Pediatric
pulmonary tuberculosis (
PPTB) remains a major cause of morbidity and mortality worldwide, particularly in less developed countries. Current techniques are inadequate for diagnosing
PPTB. This is an impediment not only for the diagnosis and treatment of
PPTB cases, but also for epidemiological investigations assessing
PPTB burden and disease transmission. Causes of misdiagnosis of
PPTB include non-specific signs/symptoms, low bacillary load, recovery methods (sputum or gastric aspirate) for obtaining a clinical sample with low bacillary yield, and the inherent low sensitivities of the diagnostic tests themselves. New diagnostic and recovery methods have recently been evaluated which may provide a means of overcoming some of these obstacles. Unfortunately, progress in developing and implementing improved diagnostic tests for
PPTB has been partially impeded by the very low priority of
PPTB in global TB control programs based on cost-effective strategies. Regardless of the cost-effectiveness of diagnosing and treating
PPTB, our moral obligation to provide access to health care demands that we evaluate and deal with this neglected group of patients. Furthermore, recent evidence indicates that
PPTB may actually be responsible for more disease transmission than previously thought. In this review, we present compelling evidence that research agendas and TB control programs should be reassessed and possibly revised to deal with the global disease caused by
PPTB.