Belgium is a country with a low prevalence of tuberculosis and an extremely low number of TB cases in children. In 2016, TB disease was reported in 27 children under 5 years of age. The origin of disease among children is often household members, although transmission outside the house can happen. Early diagnosis is vital because kids aged <5 years old are at high risk of developing a clinical illness, those <2 years old risk developing even more severe diseases.
At early February, 2020, a team of scientists reported for two outbreaks after exposure to, respectively, two teachers diagnosed as positive for pulmonary TB: one in a primary school, a nursery teacher, and another one in a private language school. The results from this study showed a transmission rate of 13% and 40%, respectively, in their courses at school. The closer contact increased the possibility of infection. TB disease was detected in, respectively, 4 and 11% of the casual contacts. Most of these children were younger than 5 years of age. TB-infected kids having active TB disease had a good compliance with recommended therapy.
The World Health Organization (WHO) recommends screening of all young children (under 5 years old) who have close contact with a person positive for pulmonary TB and also the application of Latent tuberculosis infection treatment even before symptoms’ development. Despite this knowledge, a small group of the children younger than five years without an evidence of infection has been treated with the suggested chemoprophylactic treatment in both reported cases.
It is crucial to develop a new strategy for this vulnerable group of patients. This strategy could be improved, implemented and evaluated by National Tuberculosis Control Programs that involve private and public health services. Public health authorities play an important role in raising public awareness on the risks of tuberculosis for young children.