Treatment of TB

What if my child had a positive PPD and Chest X-ray –your child has TB which will need treatment. Since TB is such a hard bacteria to kill your doctor will recommend six months of treatment with four different medications. Four in the first two months to really start to get ahead of the infection and two the last four months.

Why did they make my child give sputum samples for three days? This is one of the ways to diagnose active TB. If the samples are negative they may either delay treatment until you leave China or start treatment in China before letting you fly. The reason is even if a child has the positive X-ray the abnormalities are usually small, children don’t cough up sputum (and the TB bacteria) as much as adults and when they do there are few bacteria in it. rea

 Why does the doctor want to see my child take the medicine? -The biggest cause for people not completing their treatment successfully is folks/parents forgetting to give the medicine therefore physicians usually recommend directly observed treatment. A trained health professional other than the parents will need to see the child take each and every dose of medicine- a major hassle but TB is bad and can easily spread so killing the bacteria effectively is critical.

My child’s chest x-ray was normal but they still want to treat?  If the PPD was positive, particularly in a child coming from China, your child was exposed to TB and has some hibernating (called latent) TB in the lungs that is just too small for an X-ray to see. Even a CT scan, which can see even smaller abnormalities, will not see it but it is most likely there. Since TB can be so dangerous it should be treated. The treatment is called INH and it is taken for 9 months daily but, unlike the children with a positive X-ray the doctor doesn’t need to see your child take each dose- count your blessing where they come. In studies of children who were treated for latent TB almost 100% didn‘t have TB occur in 20 years. Some doctors will elect to watch a patient without treatment if they were in a low risk environment but China is not low risk- it is near the top of the World Health Organizations top 20 list for TB. If they do treat, they will consider also giving vitamin B6 because INH can deplete this important vitamin; in well-nourished children it is not usually given but with your child coming from a Chinese orphanage, the assumption will be that he or she is not well nourished.