Tuberculosis In Children - Causes, Symptoms, And Treatment

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In 2015, one million children aged 0-14 fell ill with tuberculosis (1). Among them, 170,000 children succumbed to the illness.

Tuberculosis (TB) is a serious illness that can be fatal in its active state. When detected early, though, you can prevent it from causing any real damage to the child’s health. Learn more about TB in children, its symptoms, causes, and treatment in this MomJunction article.

What Is Tuberculosis?

Tuberculosis is a contagious infection caused by the bacteria called Mycobacterium tuberculosis. While the TB bacteria can affect any part of the body, its illness primarily affects the lungs and the throat and is referred to as pulmonary (relating to the lungs) tuberculosis or primary tuberculosis. When the tuberculosis bacteria spreads the infection beyond the lungs, it is known as non-pulmonary or extrapulmonary tuberculosis.

  • TB can also be of the kidneys and the bones and joints, known as non-pulmonary tuberculosis, and does not spread easily.
  • Children can develop abdominal tuberculosis, which is an infection of the gastrointestinal tract, abdominal lymph nodes, pancreas, liver, and spleen.
  • The infection can also affect the reproductive or urinary tract organs.
  • Miliary TB, which is the widespread distribution of the Mycobacterium tuberculosis, is common in children aged three or less. This infection usually occurs all over the body, although it can affect only one or a few organs. The good news is that this type of TB is completely curable.
  • TB can spread to the brain and is life threatening as TB meningitis.

Primary TB is highly contagious as the bacteria spreads from one person to another through the air. So if your child is near an infected person who is sneezing, coughing, singing or even talking – in short, if a child shares breathing space with a person infected with the TB bacteria, he or she is highly likely to get infected too.

The incubation period, which is the time between infection and the development of active disease, is two to 12 weeks (2). An infected child may be contagious as long as the disease is active. Some may suppress the infection for a while but might redevelop the symptoms and also become infectious.

[ Read: Home Remedies For Cough In Children ]

The three stages of TB in children are:

  • Exposure – when the child comes into contact with an infected person.
  • Latent TB infection – when the child has contracted the bacteria in the body but has not developed the symptoms yet. The immune system, if strong, can keep the bacteria inactive for life.
  • TB disease – When the child starts to show the symptoms of TB and gets positive on the skin test and the chest X-ray.

Can a child get tuberculosis?

Though not as prevalent as it was before, tuberculosis can affect people of different age groups. It mostly attacks people aged between 25 and 44, which is also the age group most affected by HIV (3). However, in some parts of the world, TB is a huge burden with thousands of people affected and dying every year.

Children who have a weak immune system are more vulnerable than the normal kids. Also, your kid may be at risk of developing TB if he or she:

  • Lives in a country or has links to countries that have a high rate of tuberculosis cases.
  • Lives in places where the number of people with TB is high.
  • Is HIV positive.
  • Lives in a poorly ventilated house or overcrowded spaces.

Why are children vulnerable and what causes the disease in them?

Causes Of Tuberculosis In Children

The Mycobacterium tuberculosis bacteria is what causes the infection in a child. If the kid has a healthy immune system, it may help in destroying the bacteria before it spreads. In case the bacteria does escape, it spreads to other parts of the body through the blood or the lymph nodes. The TB bacteria grows slowly and is aerobic, which means it is drawn to organs like the lungs, bones, and kidneys that oxygenate.

Active tuberculosis is contagious and spreads from one person to another through the air.

Learning about the symptoms of TB in children is the only way to identify and detect the infection early and prevent it from spreading.

What Are The Symptoms Of TB In A Child?

Symptoms of the disease start to show only if the infection becomes active. Most children who are infected by the Mycobacterium tuberculosis develop active TB, but when they start showing the symptoms can vary. Therefore, the symptoms of TB can become evident in two months, or even two years after the infection. Common symptoms of tuberculosis include:

  • A cough that lasts three weeks or more
  • Loss of appetite
  • Weight loss
  • Fever
  • Night sweats and chills
  • Tiredness or lethargy

[ Read: Loss Of Appetite In Children ]

Other symptoms:

  • Pain in the chest
  • Blood in the phlegm or sputum
  • Swollen glands

Your child may have only some or all of these symptoms, which makes it difficult to determine whether or not he has the infection.

When do you call the doctor?

When the symptoms mentioned above are persistent and do not go away even after a week or two, it is time to take the child to a doctor. The night sweats, loss of appetite or even coughing may not necessarily indicate tuberculosis. But it could indicate any other bacterial infection or illness that needs to be addressed by a medical professional.

Diagnosis Of TB In Children

The symptoms of TB are so common that it is easy to overlook them as something insignificant. Therefore, a diagnosis is the only way to determine if the child has the infection or not. To diagnose TB in children, doctors would recommend a series of tests such as:

  • Sputum test or biopsy by trained lab technicians.
  • A culture test to check the activity of the bacteria. This also helps doctors know how you might respond to antibiotics.
  • X-rays to see how much damage, if any, the bacteria has done to the lungs.
  • A TB skin test is performed to check for latent TB – in this, the doctors inject a small patch of the skin on the arm with tuberculin. The skin gets raised and turns red if it has been exposed to the bacteria in the past five years.
  • The Interferon-Gamma Release Assay or IGRA tests the blood and checks immune cells to determine latent TB.

Treatment For Tuberculosis In Children

Tuberculosis can cause serious health complications in adults as well as children unless detected early on and treated. Basic treatment can take anywhere between a few weeks to a couple of months. However, it might take at least six months of treatment, medication and home care to eliminate the bacteria completely from the child’s body.

Tuberculosis is usually treated with antibiotics and other drugs to fight the bacteria. Children may be put on a six to nine-month course of isoniazid, which is an anti-TB medication for treating the latent TB infection (4). In some cases, the duration of the course may be shorter than six months.

In case the child has active TB, he or she might be asked to take three to four different medicines such as Rifampicin, Pyrazinamide and Ethambutol (5). This helps in removing the infection and preventing the bacteria from spreading to other parts of the body.

The exact course of treatment for the patient will depend on the severity, the stage of the disease and the affected organ.

[ Read: Fungal Infections In Children ]

Prevention Of TB In Children

One of the best ways to prevent tuberculosis is to get the children a shot of the Bacillus Calmette-Guerin (BCG) vaccine, which is the only vaccine for preventing TB (6). The BCG vaccine is given to babies as a part of the childhood immunization program and protects the child from different forms of disseminated TB. However, it is not given routinely in many countries.

If you have any TB or HIV patients in the family, make sure that your children are not coming in contact with the infected person until he or she has recovered significantly.

Home Care For Children With TB

Besides the treatment, children with a disease like TB need additional home care to recover soon. Usually, isolation becomes necessary when the child has XDR TB (multidrug-resistant tuberculosis). In such cases, he or she may have to be hospitalized until the infection is brought down.

In the case of other types of TB, the drugs work quickly and make the patient free of infection in a short time. You can take the child back home and continue medications.

Here are a few home care tips to follow when taking care of a child with active tuberculosis infection.

  • Make sure you give the medication in the right doses, as prescribed by the doctor. If there are any side-effects, report to the doctor immediately.
  • A healthy diet and lifestyle are also necessary to help the child gain back any weight that he or she has lost during the time.
  • Get the child to rest as much as possible, as the illness can leave them tired and lethargic at times.

Herbal Remedies For Children With TB

You can use natural ingredients and herbs to alleviate the symptoms of TB while undergoing the treatment as prescribed by the doctor. Here are some tried and tested home remedies for tuberculosis.

  1. Garlic contains compounds known as allicin and ajoene, which are anti-bacterial and prevent the growth of TB bacteria. Also, the sulfuric acid in garlic can kill the germs causing TB. Garlic is an immunity booster. You can give the child raw garlic or add it to the food you make.

[ Read: Benefits Of Garlic For Kids ]

  1. Custard Apple has rejuvenating properties found in the medicines used for treating TB. The fruit can help in alleviating the symptoms of the illness.
  • Take the pulp of the fruit (without seeds) and boil it.
  • Let it sit on low flame until the solution reduces to one-third of the original quantity.
  • Strain the liquid and give it to the kid twice a day to provide relief from the symptoms.
  1. Oranges have certain salinity in them and can help in clearing the mucus blocking the airways. The fruit also helps in boosting immunity and improving the overall health of the child.
  1. An age-old remedy is to give the child green banana juice at least twice a day, to relieve the symptoms of TB.
  1. Indian gooseberry or amla is anti-inflammatory and rich in nutrients that can give the body the needed energy to function normally. You can give the child raw gooseberries or make gooseberry and honey juice to be consumed on an empty stomach every day.
  1. Drumstick leaves have anti-bacterial properties that can fight the TB-causing bacteria. Boil the leaves in water, let it cool and add salt and lemon. Give this solution to the child to drink every morning on an empty stomach.
  1. Mint helps in loosening the mucus, making it easier to remove it from the body. It boosts immunity and increases the body’s resistance to infections.
  1. Pineapple is another natural remedy for clearing the mucus formed by the bacteria. A glass of fresh pineapple juice every day can help in hastening the recovery process.
  1. Celery’s antispasmodic properties help in treating pulmonary TB in both children and adults.
  1. Black pepper is often used to relieve chest pain and eliminate the mucus blocking the airways in the lungs. The anti-inflammatory properties of this spice provide relief from coughing and the inflammation caused by the bacteria.
  1. Walnuts help in boosting the immune system, enabling the child to fight the bacteria and prevent it from spreading.
  1. Green tea has antioxidant and immunity boosting properties, which make it an excellent natural remedy to treat tuberculosis.
  1. Sunlight can help kill the germs that make TB contagious. Regular sunbathing is a good idea if the climate is favorable.
  1. Milk contains calcium, the lack of which is considered to be one of the causes of TB. So give the child a glass of raw, non-pasteurized milk to aid the treatment of tuberculosis.

[ Read: Benefits Of Milk For Kids ]

Tuberculosis in children is not a disease that you should take lightly. Whether it is latent or active, you need to take utmost care of the child to ensure he gets the necessary treatment and nutrition to fight the disease-causing bacteria.

You also need to support the child mentally, as the disease will have a strong and long-lasting impact on them. They might be traumatized with the pain of not being able to live like a normal child. Your support and care will help them fight the situation.

Have an experience to share? Leave a comment in the below section.

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Dr. Elna Gibson

(MBChB, MMed, Paeds)
Dr. Elna Gibson is a general pediatrician. She did her MBChB and specialization as a pediatrician in South Africa at the University of Pretoria. She obtained MMed Pediatrics (masters) with distinction in 1993. As a young specialist, Dr. Gibson spent some time in the Netherlands, and then settled in the Vaal Triangle where she has practiced for 25 years. She... more

Dr Bisny T. Joseph

Dr. Bisny T. Joseph is a Georgian Board-certified physician. She has completed her professional graduate degree as a medical doctor from Tbilisi State Medical University, Georgia. She has 3+ years of experience in various sectors of medical affairs as a physician, medical reviewer, medical writer, health coach, and Q&A expert. Her interest in digital medical education and patient education made... more