The Value of Chest Radiography in Tuberculosis Preventive Treatment Screening in Children and Adolescents

Marais and Graham discuss the study of Huang and colleagues in which they evaluated the diagnostic and prognostic value of chest radiography in children exposed to infectious tuberculosis (TB) in Peru and measured the efficacy of isoniazid preventive therapy (IPT) in those with radiographic abnormalities. Asymptomatic children with abnormal chest radiographs were found to be 25 times more likely to have coprevalent TB and 26 times more likely to be diagnosed with incident TB during follow-up than asymptomatic children with normal chest films. IPT was also found to be highly effective in preventing disease progression, with 82% efficacy against incident TB documented among 'asymptomatic' children who had an abnormal chest radiograph at baseline. Clearly, these important findings require careful consideration for programmatic implementation.