6.2 Screening child contacts of patients with TB

Child contacts are at high risk of TB disease, and the risk varies substantially by age. Newborn infants are at particularly high risk of infection with TB if the mother had untreated TB disease when they were born. Apart from the risk of exposure because of close proximity to adults in a household with TB, children < 5 years who are infected with TB have a 19% chance of progression to TB disease within 2 years (39). Most paediatric mortality occurs in this age group, with 80% of paediatric deaths from TB occurring in children < 5 years (40). An infant infected with TB has a very high risk of rapidly developing TB disease and dying. Among infants (< 1 year) infected with M. tuberculosis, 20–50% will develop TB disease, almost all of them within 1 year of infection (39-41). The risk of progression to TB disease among older children and adolescents (5–14 years) in the 2 years after TB infection is somewhat lower but still consequential, at 9% (39). The high risk of progression to TB disease and the associated high mortality rates underline the importance of screening children exposed to close contacts with TB.

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