How to tell chronic cough from TB
AS the world commemorates World tuberculosis (TB) Day on Thursday (March 24), many children continue to die of the disease. For many, the disease first presents as an on and off cough, resisting most antibiotic treatment. <br>
By Agnes Kyotalengerire
AS the world commemorates World tuberculosis (TB) Day on Thursday (March 24), many children continue to die of the disease. For many, the disease first presents as an on and off cough, resisting most antibiotic treatment.
Dr. Eric Wobudeya, a paediatrician at Mulago Hospital, says TB is more devastating and fatal in children. Worldwide, over 1,000,000 children develop TB and 100,000 die annually.
Wobudeya says with the prevalence of HIV/AIDS, more children are succumbing to TB, adding that children with HIV are 10 times more likely to die than those with TB alone. However, he says TB in children is curable, and early diagnosis helps in effective treatment.
Cause
TB is an airborne disease caused by TB bacilli which primarily affects the lungs. In some cases the lymph nodes, intestines, kidneys, joints, brain, spine and skin are also affected.
How is TB spread
Victoria Nakibuuka, a paediatrician at Nsambya Home Care, says children usually get TB infection when they are exposed to the germs from sputum of an infected person, or by inhaling droplets from the environment when an infected person sneezes or coughs.
A child, especially aged under two, needs only to inhale a small number of these germs to be infected. Nakibuuka, however, notes that young children below four years are at higher risk of developing active TB because their immune system is less developed.
The chance of developing the disease is greatest shortly after infection. Nakibuuka cautions that when children present with active tuberculosis, family members and other close contacts should be investigated for TB and treated.
She adds that the current policy by the health ministry stipulates that if an adult has active TB, children in the home aged five and below must be given Isoniazid, one of the four first-line TB drugs. This reduces chances of them getting full blown TB.
Dr. Nanyonga Musoke, a paediatrician at Nsambya Home Care, says most children contract the disease from their infected parents, especially mothers. “Unless by the time of delivery the infected parent had undergone at least two weeks of TB medication, the baby is at a higher risk,†she adds.
Who is at risk?
Children below the age of two and people living with HIV/AIDS are particularly at risk because they have an under developed and compromised immune system. Other children at risk are those born to mothers with TB.
Symptoms
Wobudeya says TB and malnutrition often go together, and a child with the disease may fail to gain weight, lose energy, have cough lasting for more than two weeks, look unhealthy, have prolonged fever and is tired all the time. In addition, a child with TB may find it hard to breathe.
Diagnosis
“The diagnosis of TB in children, particularly those below five, is one of the biggest challenges facing health workers in Uganda,†notes Nakibuuka.
She explains that usually such children cannot cough up enough sputum required for laboratory investigations.
Diagnosis is thus largely based on the clinical features of cough and weight loss, with a history close contact with a TB patient. With the help of tuberculin skin and chest x-ray tests, a doctor can get an idea of the extent of the damage in a baby’s body.
AS the world commemorates World tuberculosis (TB) Day on Thursday (March 24), many children continue to die of the disease. For many, the disease first presents as an on and off cough, resisting most antibiotic treatment.
Dr. Eric Wobudeya, a paediatrician at Mulago Hospital, says TB is more devastating and fatal in children. Worldwide, over 1,000,000 children develop TB and 100,000 die annually.
Wobudeya says with the prevalence of HIV/AIDS, more children are succumbing to TB, adding that children with HIV are 10 times more likely to die than those with TB alone. However, he says TB in children is curable, and early diagnosis helps in effective treatment.
Cause
TB is an airborne disease caused by TB bacilli which primarily affects the lungs. In some cases the lymph nodes, intestines, kidneys, joints, brain, spine and skin are also affected.
How is TB spread
Victoria Nakibuuka, a paediatrician at Nsambya Home Care, says children usually get TB infection when they are exposed to the germs from sputum of an infected person, or by inhaling droplets from the environment when an infected person sneezes or coughs.
A child, especially aged under two, needs only to inhale a small number of these germs to be infected. Nakibuuka, however, notes that young children below four years are at higher risk of developing active TB because their immune system is less developed.
The chance of developing the disease is greatest shortly after infection. Nakibuuka cautions that when children present with active tuberculosis, family members and other close contacts should be investigated for TB and treated.
She adds that the current policy by the health ministry stipulates that if an adult has active TB, children in the home aged five and below must be given Isoniazid, one of the four first-line TB drugs. This reduces chances of them getting full blown TB.
Dr. Nanyonga Musoke, a paediatrician at Nsambya Home Care, says most children contract the disease from their infected parents, especially mothers. “Unless by the time of delivery the infected parent had undergone at least two weeks of TB medication, the baby is at a higher risk,†she adds.
Who is at risk?
Children below the age of two and people living with HIV/AIDS are particularly at risk because they have an under developed and compromised immune system. Other children at risk are those born to mothers with TB.
Symptoms
Wobudeya says TB and malnutrition often go together, and a child with the disease may fail to gain weight, lose energy, have cough lasting for more than two weeks, look unhealthy, have prolonged fever and is tired all the time. In addition, a child with TB may find it hard to breathe.
Diagnosis
“The diagnosis of TB in children, particularly those below five, is one of the biggest challenges facing health workers in Uganda,†notes Nakibuuka.
She explains that usually such children cannot cough up enough sputum required for laboratory investigations.
Diagnosis is thus largely based on the clinical features of cough and weight loss, with a history close contact with a TB patient. With the help of tuberculin skin and chest x-ray tests, a doctor can get an idea of the extent of the damage in a baby’s body.