Delayed diagnosis of pulmonary tuberculosis in a 13-year-old Malawian boy

Childhood tuberculosis (TB) is a significant global health burden. There are more than 1 million new cases of childhood TB annually. Despite this, many national TB control programs largely focus on identification and treatment of smear positive adults. Early case detection is essential if childhood TB is to be controlled and eradicated.Delayed diagnosis of TB is associated with more advanced disease and worse treatment outcomes. Younger children who go undiagnosed for long periods are at risk of developing severe pulmonary and extrapulmonary disease, such as meningitis. Additionally, advanced childhood TB is a common respiratory cause of death in TB-endemic areas. Undoubtedly, delayed diagnosis contributes significantly to TB-related morbidity and mortality.Diagnostic delay may be divided into patient delay, the duration between development of symptoms and presentation to healthcare provider, and healthcare provider delay, the duration between presentation and initiation of appropriate treatment.