Tuberculosis, aka TB, is the most deadly infectious disease. WHO estimates more deaths from TB than deaths from malaria and AIDS. Not only attacks adults, TB can also attack children. It is estimated that 10-15% of TB cases in Indonesia attack children aged 0-14 years.
Differences in adult tuberculosis and tuberculosis in children
Tuberculosis in children is a unique case and has a different problem from adult TB. The 2012 tuberculosis report in Indonesia stated that the number of cases of child TB was 8.2% with figures varying between 1.7-15.6% from each province. This striking difference shows that it is not easy to recognize tuberculosis in children because the symptoms are not as typical as in adult TB.
Sometimes parents run their children to hospital because of other symptoms, which at a glance like there is no connection with the biggest cause of child mortality in these developing countries. Therefore, let us learn how to recognize TB infection in children so that your children can be treated more immediately.
Two ways of early detection of tuberculosis in children
The case of TB in children is like an iceberg in the ocean. The amount is a lot, but often parents are late to recognize. Actually there are two fairly easy approaches that we can do as early detection, namely the investigation of children who have close contact with active and infectious adult TB patients, as well as children who come to health services with symptoms and clinical signs that lead to TB.
Children who have close contact with infectious TB patients
The close contact in question is a child who lives at home or often meets infectious TB patients, such as family members, neighbors, or relatives who interact with children daily. Report immediately if there is someone in your home who has infectious TB, whether pulmonary TB or other TB. Usually infectious TB is suffered by adult patients whose sputum examination results show the presence of germs (usually called positive smear). Even though the child does not show symptoms of illness, you must check the child with a doctor for TB screening and prevention efforts
Children who show clinical signs and symptoms
Child TB is a systemic infectious disease, and the organ most often affected is the lung, although other organs can also be attacked by these germs. Clinical symptoms of TB in children can be systemic /general symptoms or according to related organs.
6 common tuberculosis symptoms in children
Appetite decreases or doesn't exist at all (anorexia), accompanied by failure to thrive. In contrast to adults whose main symptoms are long coughing, in childhood TB the first symptom parents recognize is the growth of smaller children of their age. The child looks thin.
- Weight loss for 2-3 consecutive months without a clear cause OR
- Weight doesn't increase enough, OR
- Weight does not increase in 1 month after good nutrition improvement efforts.
flagging or malaise . Children look lazy and not powerful to do activities. Children also look less active when invited to play.
Long cough 3 weeks or more. Coughing is non-remitting which is a cough that never subsides and gets worse over time.
Old fever (2 weeks or more) and /or recurring for no apparent reason. Fever is generally not high (just warm body) and lasts a long time. Can also be accompanied by night sweats. Fever experienced is not caused by typhoid fever (typhoid), urinary tract infections, or malaria.
Sweat night . This symptom is not typical in children, but can occur. But we must also note, if only night sweats are not accompanied by other common symptoms, this may not be a specific symptom of TB in children.
Symptoms in children if TB germs attack other organs
Infection with TB germs is not limited to the lungs. All organs in the body can be attacked by these germs. Therefore, special symptoms will also arise depending on the organ affected. Below are organs that are often attacked by TB in children.
1. Glandular tuberculosis
This type of TB attacks the most in the neck area, with symptoms of enlarged lymph nodes with a diameter of ≥ 1 cm. Usually the lumps are attached to each other so that they are shaped like marbles lined with chewy consistency. This lump is not painful.
2. Brain tuberculosis and brain membranes (TB meningitis)
TB bacteria are also easily spread to the brain. If the brain membrane is affected, the child will show symptoms of fuss, headache, stiffness, until seizures. This happens due to the involvement of the nerves of the brain affected. Be careful if children tend to be quiet and sleepy. That is a sign that the child has decreased consciousness
3. Bone tuberculosis
Depends on the part of the bone affected, such as:
- Spinal tuberculosis (spondylitis): protrusion of the spine (gibbus).
- Pelvic bone TB (coccitis): limps, walking disorders, or signs of inflammation in the pelvic area.
- Knee bone TB (gonitis): limping and /or swelling in the knee for no apparent reason.
- TB of the leg and hand bones (spina ventosa /daktilitis): swelling of the joints of the hands or feet
Also called skin tuberculosis. Symptoms are characterized by a wound or ulcer accompanied by the presence of a skin fistula /bridge between the edges of the wound (skin bridge). Usually the child is accompanied by fever due to the ongoing infection process.
5. Intestinal tuberculosis
The presence of digestive symptoms, such as bloating, diarrhea, abdominal pain. Usually children are very fussy. Complications of intestinal TB are inflammation of the lining of the stomach which is commonly called TB peritonitis.
6. Kidney tuberculosis
Suspected if symptoms of kidney problems are found, namely urination, urine that is too thick, and low back pain for no apparent reason and with suspected TB infection.
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