Childhood Tuberculosis: Epidemiology, Etiology, Pathophysiology, Pathogenesis, Risk Factors, Prevention and Diagnosis: A Narrative Review
DOI:
https://doi.org/10.6000/1929-6029.2025.14.38Keywords:
Chilhood Tuberculosis, Epidemiology, Pathogenesis, Diagnosis, PreventionAbstract
Background: Tuberculosis is a chronic infectious disease caused by Mycobacterium tuberculosis bacteria. These bacteria are rod-shaped and acid-resistant, so they are often known as acid-resistant bacilli (BTA). Children are at high risk of TB infection, especially infants and toddlers. Children infected with TB are at risk of developing severe TB disease that can lead to death or long-term disability. This article review focuses on a brief introduction to anemia, its etiology, pathophysiology, impact and preventive measures.
Methods: Major databases including Scopus, Pubmed, Proquest, Google Scholar, and Science Direct were searched for articles related to pediatric tuberculosis. The keyword used in the literature search was “pediatric tuberculosis”. The time frame of the articles obtained ranged from 2016 to 2023.
Results: This study shows that the burden of pediatric tuberculosis (TB) remains high globally and nationally. WHO reported 1.2 million cases of pediatric TB with more than 200,000 deaths, mainly in children under five. In Indonesia, pediatric TB cases increased from 110,881 (2022) to 129,798 (2023), with bacteriological confirmation still low, especially in children <5 years. In South Sulawesi, the trend of cases is decreasing, but in Parepare City it has increased from 16 to 21 cases. The main obstacles include difficulty in diagnosis, limited facilities, low coverage of TB preventive therapy (TPT), and suboptimal handling of drug-resistant TB.
Conclusion: Diagnosing TB in children remains difficult due to limited tools and low bacterial presence. Many cases go underdiagnosed or overdiagnosed, while drug-resistant TB poses added risks. Prevention includes BCG vaccination, controlling risk factors, and TPT. Disparities in diagnosis and treatment persist. Early detection, family education, and access to care are vital. Strengthening community and household approaches can narrow diagnostic gaps and prevent complications in childhood TB.
References
Modugu HR, et al. Influence of gender and parental migration on IYCF practices in 6-23-month-old tribal children in Banswara district , India : findings from the cross-sectional Panchsheeel study. BMC Nutrition 2022; pp. 1-16. DOI: https://doi.org/10.1186/s40795-021-00491-7
Sari M. Terapi Tuberkulosis. Jurnal Medika Hutama 2021; 03(01): 1571-1575.
Nisak K, Fahdhienie F, Ichwansyah F. Faktor Risiko Kejadian Tuberkulosis (TB) Paru Di Wilayah Kerja Puskesmas Ingin Jaya Kabupaten Aceh Besar. Jurnal Promotif Preventif 2024; 7(1): 90-96. DOI: https://doi.org/10.47650/jpp.v7i1.1161
Kurniasih E, Daris H. Tuberculosis-Mengenali Penyebab, Cara Penularan, dan Penanggulangan 2017; 1-172. http://repo.akperngawi.ac.id/hamidatus_daris_saadah/BUKUAJAR 1.pdf
Wowiling S, Rahmat HD, Faradilla MS. Pengaruh Edukasi Tentang Penyakit Tb Paru Terhadap Sikap Penerimaan Anggota Keluarga yang Menderita TB Paru di Poliklinik TB DOTS (Directly Observed Treatment Short-Course) RSU GMIM Pancaran Kasih Manado. Jurnal Kesehatan Amanah 2021; 5(1): 78-102. DOI: https://doi.org/10.57214/jka.v5i1.201
WHO. 2022 Fact sheets TB Anak Dunia.
Soekotjo FN, Sudarwati S, Alam A. Clinical Profile of TB in Children at Pediatric Outpatient Clinic Hasan Sadikin Hospital Bandung 2016 Profil Klinis Pasien TB Anak di Poli Rawat Jalan Rumah Sakit Dokter Hasan Sadikin Bandung Tahun 2016. Journal of Medicine and Health 2019; 2(3): 818-827. DOI: https://doi.org/10.28932/jmh.v2i3.1221
Dashboard TBI. Dashboard TBC Indonesia. Tbindonesia. or.Id 2023; p. 1. Available at: https://tbindonesia.or.id/ pustaka-tbc/dashboard/.
Detjen AK, et al. Tuberculosis and integrated child health - Rediscovering the principles of Alma Ata. International Journal of Infectious Diseases 2019; 80: S9-S12. DOI: https://doi.org/10.1016/j.ijid.2019.02.042
Tola H, et al. National treatment outcome and predictors of death and treatment failure in multidrug-resistant tuberculosis in Ethiopia: A 10-year retrospective cohort study. BMJ Open 2021; 11(8): 1-9. DOI: https://doi.org/10.1136/bmjopen-2020-040862
Cristina A, et al. ‘Epidemiological aspects, clinical mani- festations , and prevention of pediatric tuberculosis from the perspective of the End TB Strategy’ 2018; 44(2): 134-144. DOI: https://doi.org/10.1590/s1806-37562017000000461
Souza LL, et al. Causes of multidrug-resistant tuberculosis from the perspectives of health providers: challenges and strategies for adherence to treatment during the COVID-19 pandemic in Brazil. BMC Health Services Research 2021; 21(1): 1-10. DOI: https://doi.org/10.1186/s12913-021-07057-0
Kementerian Kesehatan RI. Pedoman Nasional Pelayanan kedokteran Tata Laksana Tuberkulosis 2020.
Kementerian Kesehatan RI, Petunjuk Teknis Tata Laksana Tuberkulosis Anak dan Remaja. Jakarta 2023.
WHO (2021) World Health Statictics 2021.
Kementerian Kesehatan RI, Petunjuk Teknis Tata Laksana Tuberkulosis Anak dan Remaja. Jakarta 2023.
Dwipayana IMG. Mengenali Gambaran Penyakit Tuberkulosis Paru Dan Cara Penanganannya. Widya Kesehatan 2022; 4(1): 1-14. DOI: https://doi.org/10.32795/widyakesehatan.v4i1.2806
Mar’iyah K, Zulkarnain. Patofisiologi penyakit infeksi tuberkulosis. In Prosiding Seminar Nasional Biologi 2021; 7(1): 88-92.
Brier J, lia dwi jayanti. Pedoman Nasional Pelayanan Kedokteran 2020; 21(1): 1-9.
Gunadi B, Saksono D, Pramono Y, Agustina I. Buku panduan tenaga medis dan tenaga kesehatan tuberkulosis 2025; 1-38.
Maison DP. Tuberculosis pathophysiology and anti-VEGF intervention. Journal of Clinical Tuberculosis and Other Mycobacterial Diseases 2022; 100300. DOI: https://doi.org/10.1016/j.jctube.2022.100300
Gannika L. Tingkat Pengetahuan Keteraturan Berobat Dan Sikap Klien Terhadap Terjadinya Penyakit Tbc Paru Di Ruang Perawatan I Dan Ii Rs Islam Faisal Makassar. Jurnal Ilmiah Kesehatan Sandi Husada 2016; 4(1): 55-62. DOI: https://doi.org/10.35816/jiskh.v4i1.86
Mar’iyah K, Zulkarnain. Patofisiologi penyakit infeksi tuberkulosis. In Prosiding Seminar Nasional Biologi 2021; 7(1): 88-92.
Wijaya MSD, Mantik MFJ, Rampengan NH. Faktor Risiko Tuberkulosis pada Anak 2021; 9(28): 124-133. DOI: https://doi.org/10.35790/ecl.v9i1.32117
Amelia DR, Situmorang L. Risk Factors of Tuberculosis Transmission in Children in Fakfak Hospital, West Papua 2022; 3(3): 335-338. DOI: https://doi.org/10.51542/ijscia.v3i3.6
Bonnet M, Vasiliu A, Tchounga BK, Cuer B, Fielding K, Ssekyanzi B, Tchakounte Youngui B, Cohn J, Dodd PJ, Tiendrebeogo G, Tchendjou P, Simo L, Okello RF, Kuate Kuate A, Turyahabwe S, Atwine D, Graham SM, Casenghi M., Chauvet S, Nahabwe M. Effectiveness of a community-based approach for the investigation and management of children with household tuberculosis contact in Cameroon and Uganda: a cluster-randomised trial. The Lancet Global Health 2023; 11(12): e1911-e1921.
Malhotra A, Nonyane BAS, Shirey E, Mulder C, Hippner P, Mulatu F, Ratshinanga A, Mitiku P, Cohn S, Conradie G, Chihota V, Chaisson RE, Churchyard GJ, Golub J, Dowdy D, Sohn H, Charalambous S, Bedru A, Salazar-Austin N. Pragmatic cluster-randomized trial of home-based preventive treatment for TB in Ethiopia and South Africa (CHIP-TB). Trials 2023; 24(1): 1-14. DOI: https://doi.org/10.1186/s13063-023-07514-7
Abelti E, Dememew Z, Gebreyohannes A, Alemayehu Y, Terfassa T, Janfa T, Jerene D, Suarez P, Datiko D. Community-Based Tuberculosis Preventive Treatment Among Child and Adolescent Household Contacts in Ethiopia. Tropical Medicine and Infectious Disease 2025; 10(4): 1-15. DOI: https://doi.org/10.3390/tropicalmed10040102
Clark RA, Weerasuriya CK, Portnoy A, Mukandavire C, Quaife M, Bakker R, Scarponi D, Harris RC, Rade K, Mattoo SK, Tumu D, Menzies NA, White RG. New tuberculosis vaccines in India: modelling the potential health and economic impacts of adolescent/adult vaccination with M72/AS01E and BCG-revaccination. BMC Medicine 2023; 21(1): 1-13. DOI: https://doi.org/10.1186/s12916-023-02992-7
Huynh J, Abo YN, Triasih R, Singh V, Pukai G, Masta P, Tsogt B, Luu BK, Felisia F, Pank N, Aung A, Morton A, Azzopardi P, Koesoemadinata RC, Alisjahbana B, Hill PC, Marais BJ, Chiang SS, Graham SM. Emerging evidence to reduce the burden of tuberculosis in children and young people. International Journal of Infectious Diseases 2025; 155: 107869. DOI: https://doi.org/10.1016/j.ijid.2025.107869
Wilson L, Gracie L, Kidy F, Thomas GN, Nirantharakumar K, Greenfield S, Manaseki-Holland S, Ward DJ, Gooden TE. Safety and efficacy of tuberculosis vaccine candidates in low- and middle-income countries: a systematic review of randomised controlled clinical trials. BMC Infectious Diseases 2023; 23(1): 1-11. DOI: https://doi.org/10.1186/s12879-023-08092-4
Jannah RZ, Azizah R, Jalaludin JB, Sulistyorini L, Lestari KS. Meta-Analysis Study: Environmental Risk Factors of Tuberculosis (Tb). Jurnal Kesehatan Lingkungan 2023; 15(2): 84-91. DOI: https://doi.org/10.20473/jkl.v15i2.2023.84-91
Susanti N, Ashar YK, Siregar PA, Rezebri M, Adinda D, Iqbal M, Islam U, Sumatera N, Tapanuli K, Health T, Ahqaff U. Al. Risk Factors for the Home Physical Environment and the Incidence of Childhood Tuberculosis. Contagion : Scientific Periodical of Public Health and Coastal Health 2022; 6(2): 1510-1518. DOI: https://doi.org/10.30829/contagion.v6i2.21314
Wulandari R, Budiyono B, Sulistiyani S, Wahyuningsih E. the Relationship Between Ventilation and Physical Quality of Houses With Pulmonary Tuberculosis Cases in the Working Area of Sragen Primary Healthcare Center, Sragen Regency. Jurnal Kesehatan Lingkungan 2023; 15(1): 76-83. DOI: https://doi.org/10.20473/jkl.v15i1.2023.76-83
Moore BK, Graham SM, Nandakumar S, Doyle J, Maloney SA. Pediatric Tuberculosis: A Review of Evidence-Based Best Practices for Clinicians and Health Care Providers. In Pathogens 2024; 13(6). DOI: https://doi.org/10.3390/pathogens13060467
Siddalingaiah N, Chawla K, Nagaraja SB, Hazra D. Risk factors for the development of tuberculosis among the pediatric population: a systematic review and meta-analysis. European Journal of Pediatrics 2023; 182(7): 3007-3019. DOI: https://doi.org/10.1007/s00431-023-04988-0
Xiang S, Chen Z, Dai Z, Wang F. Global burden of lower respiratory infections attributable to secondhand smoke among children under 5 years of age, 2010–2019: a systematic analysis of the global burden of disease study 2019. BMC Public Health 2023; 23(1): 1-12. DOI: https://doi.org/10.1186/s12889-023-16848-5
Wongchana T, Songthap A. Factors affecting tuberculosis (TB) prevention behaviors among household contacts in Phitsanulok Province, northern Thailand: implications for TB prevention strategy plan. BMC Infectious Diseases 2024; 24(1). DOI: https://doi.org/10.1186/s12879-024-10327-x
Yadav BK, Singh P, Satapathy P, Arasu PT. Association between biomass cooking fuels and prevalence of tuberculosis among households: a cross-sectional study from 2019 - 2021 in India. BMC Public Health 2024; 24(1). DOI: https://doi.org/10.1186/s12889-024-20789-y
Jafta N. Association of Childhood Tuberculosis with Exposure to Indoor Air Pollution. BMC Public Health 2019; 19(275): 1-11. DOI: https://doi.org/10.1186/s12889-019-6604-9
Rahmawati A, Utomo B, Makhfudli M, Wulandari SM, Abdullah KL. Peer group support and motivational interviewing interventions impact parents’ behavior in preventing tuberculosis among children. The Journal of Palembang Nursing Studies 2024; 3(1): 5-13. DOI: https://doi.org/10.55048/jpns101
Benjumea-Bedoya D, Villegas Arbeláez E, Martínez-Peñaloza D, Beltrán-Arroyave CP, Restrepo Gouzy AV, Marín D, Cadavid Álvarez LM, Molinares B, Montes Zuluaga FN, Pulido Duarte H, Suárez Parra PM, Alzate Ángel JC, Vélez-Parra G, Realpe T, Vásquez Villa M, Ríos Buitrago SY, Puerta Zapata J, Arango García LM, Perea Torres Y, Robledo J. Implementation of an integrated care strategy for child contacts of tuberculosis patients: a quasi-experimental study protocol. BMC Pediatrics 2023; 23(1): 1-9. DOI: https://doi.org/10.1186/s12887-022-03798-x
Marx FM, de Villiers A. Decentralising screening and preventive treatment among children exposed to tuberculosis in the household. The Lancet Global Health 2023; 11(12): e1836-e1837. DOI: https://doi.org/10.1016/S2214-109X(23)00503-X
Austin NS, Bergman AJ, Mulder C, Tudor C, Mulatu F, Conradie G, Chaisson RE, Golub JE, Churchyard G, Bedru A., Kerrigan D. Improving access to tuberculosis preventive treatment for children in Ethiopia : designing a home - based contact management intervention for the CHIP - TB trial through formative research. BMC Health Services Research 2024.
Hirsch-Moverman Y, Mantell JE, Lebelo L, Howard AA, Hesseling AC, Nachman S, Frederix K, Maama LB, El-sadr WM. Provider attitudes about childhood tuberculosis prevention in Lesotho : a qualitative study 2020; 0: 1-8. DOI: https://doi.org/10.1186/s12913-020-05324-0
Downloads
Published
How to Cite
Issue
Section
License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Policy for Journals/Articles with Open Access
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are permitted and encouraged to post links to their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work
Policy for Journals / Manuscript with Paid Access
Authors who publish with this journal agree to the following terms:
- Publisher retain copyright .
- Authors are permitted and encouraged to post links to their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work .
