Ethical dilemmas in diagnosis and management of latent tuberculosis infections in children

In latent tuberculosis infection (LTBI), there are no clinical or radiographic symptoms of active tuberculosis (TB), although immunological tests are positive. Meanwhile, the risk of progression from LTBI to active TB remains high, especially in children. It is estimated that a quarter of the world’s population has LTBI. Identifying LTBI as a predictor of active TB represents a major public health achievement, as preventive activities can help stop the spread of TB in many cases. Phthisiologists specialize in the diagnosis, monitoring, and treatment of children with LTBI. Because the process is prolonged, pediatricians actively monitor and care for somatic issues in children with LTBI. During examination and treatment, both doctors and patients — together with their parents — may encounter numerous ethically challenging situations that significantly affect the quality of medical care and treatment outcomes for children with LTBI.