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Review
. 2022 Mar;16(3):273-284.
doi: 10.1080/17476348.2022.2043747. Epub 2022 Feb 28.

Tuberculosis in children with severe acute malnutrition

Bryan J Vonasek  1 , Kendra K Radtke  2 , Paula Vaz  3 , W Chris Buck  4 , Chishala Chabala  5 , Eric D McCollum  6   7 , Olivier Marcy  8 , Elizabeth Fitzgerald  9 , Alexander Kondwani  10 , Anthony J Garcia-Prats  1
Affiliations
Review

Tuberculosis in children with severe acute malnutrition

Bryan J Vonasek et al. Expert Rev Respir Med. 2022 Mar.

Erratum in

  • Correction.
    [No authors listed] [No authors listed] Expert Rev Respir Med. 2022 May;16(5):i. doi: 10.1080/17476348.2022.2092965. Epub 2022 Jun 23. Expert Rev Respir Med. 2022. PMID: 35734892 No abstract available.

Abstract

Introduction: With growing attention globally to the childhood tuberculosis epidemic after decades of neglect, and with the burden of severe acute malnutrition (SAM) remaining unacceptably high worldwide, the collision of these two diseases is an important focus for improving child health.

Areas covered: This review describes the clinical and public health implications of the interplay between tuberculosis and SAM, particularly for children under the age of five, and identifies priority areas for improved programmatic implementation and future research. We reviewed the literature on PubMed and other evidence known to the authors published until August 2021 relevant to this topic.

Expert opinion: To achieve the World Health Organization's goal of eliminating deaths from childhood tuberculosis and to improve the abysmal outcomes for children with SAM, further research is needed to 1) better understand the epidemiologic connections between child tuberculosis and SAM, 2) improve case finding of tuberculosis in children with SAM, 3) assess unique treatment considerations for tuberculosis when children also have SAM, and 4) ensure tuberculosis and SAM are strongly addressed in decentralized, integrated models of providing primary healthcare to children.

Keywords: Childhood tuberculosis; severe acute malnutrition; tuberculosis.

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References

    1. Basu Roy R, Whittaker E, Seddon JA, et al. Tuberculosis susceptibility and protection in children. Lancet Infect Dis. 2019;19:e96–e108. Available from: 10.1016/S1473-3099(18)30157-9. - DOI - PMC - PubMed
    1. Reuter A, Hughes J, Furin J. Challenges and controversies in childhood tuberculosis. Lancet. 2019;394:967–978. Available from: 10.1016/S0140-6736(19)32045-8. - DOI - PubMed
    1. World Health Organization. Roadmap towards ending TB in children and adolescents [Internet]. 2nd ed. Geneva; 2018. Available from: http://www.who.int/tb/publications/2018/tb-childhoodroadmap/en/.

    2. *This foundational report from the WHO gives an overview of the key challenges to decreasing pediatric TB and outlines key actions for addressing these challenges.

    1. World Health Organization. Guideline: updates on the Management of Severe Acute Malnutrition in Infants and Children [Internet]. Geneva; 2013. Available from: https://apps.who.int/iris/bitstream/handle/10665/95584/9789241506328_eng.... - PubMed
    1. Ibrahim MK, Zambruni M, Melby CL, et al. Impact of Childhood Malnutrition on Host Defense and Infection. Clin Microbiol Rev. 2017;30:919–971. - PMC - PubMed

    2. **This review gives a broad overview of the immunologic consequences of malnutrition in children and the infections, including TB, to which malnourished children are therefore susceptible.

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