Surreal illustration of childhood vs. adult tuberculosis

Tuberculosis in Children vs. Adults: What Are The Key Differences?

Lena Kashyap in Health & Wellness January 2026 • 4 min read.

"A new study from Abidjan reveals significant contrasts in how TB manifests and affects children compared to adults, crucial for improving diagnosis and treatment strategies."

Tuberculosis (TB) remains a significant global health challenge, particularly in developing countries. While often thought of as an adult disease, TB affects children substantially, accounting for an estimated 5% to 20% of all TB cases worldwide. Understanding how TB presents differently in children versus adults is crucial for effective diagnosis, treatment, and public health management.

A recent study conducted in Abidjan, Côte d'Ivoire, sheds light on the specific differences between childhood TB (TBE) and adult TB (TBA). This retrospective analysis, which examined data from thousands of TB cases, highlights key variations in epidemiology, clinical presentation, and treatment outcomes. The findings offer valuable insights for healthcare professionals and policymakers aiming to improve TB control strategies.

This article explores the salient points of the Abidjan study, providing a comprehensive overview of how TB uniquely impacts children. By understanding these differences, we can advocate for more targeted interventions, ultimately reducing the burden of this disease on vulnerable populations.

Key Differences in TB Presentation: Children vs. Adults

Surreal illustration of childhood vs. adult tuberculosis

The study in Abidjan meticulously compared 2,617 cases of childhood TB (TBE) with 36,648 cases of adult TB (TBA), uncovering notable distinctions:

One of the most striking differences was in the male-to-female ratio. Among children with TB, the ratio was nearly equal (0.93), indicating that the disease affects both sexes almost uniformly. In contrast, adult TB cases showed a clear male predominance, with a ratio of 1.50. This suggests that gender-related factors, such as occupational exposures or social behaviors, may play a more significant role in TB transmission among adults.

HIV Co-infection: Children with TB had a significantly lower rate of HIV co-infection (24.5%) compared to adults (44%).
Type of TB: The study revealed differences in the types of TB prevalent in children versus adults. Pulmonary TB (TB affecting the lungs) was common in both groups, but children were more likely to have smear-negative pulmonary TB.
Location of TB: Extrapulmonary TB (TB occurring outside the lungs) also showed variations in location. Lymph node involvement was more frequent among children (30.1%) than adults (12.1%), while pleural TB (TB affecting the lining of the lungs) was more common in adults (51.3%) compared to children (26.2%).
Treatment Outcomes: Children experienced better treatment outcomes compared to adults. The rate of treatment failure or death was significantly lower in children (1.9%) than in adults (3.9%).

These distinctions underscore the importance of considering age-specific factors in the diagnosis and management of TB. Healthcare providers need to be aware of the varied clinical presentations and risk factors associated with TB in children to ensure timely and appropriate care.

Tailoring TB Strategies for Children: A Call to Action

The Abidjan study provides critical insights into the unique characteristics of tuberculosis in children. By recognizing these differences in presentation, HIV co-infection rates, and treatment outcomes, healthcare systems can develop more targeted and effective strategies to combat TB in this vulnerable population. This includes focusing on early diagnosis, tailored treatment regimens, and preventive measures, ultimately reducing the burden of TB and improving the health and well-being of children worldwide.

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Everything You Need To Know

What are the key differences in male-to-female ratios among children and adults affected by Tuberculosis?

In children with Tuberculosis (TBE), the male-to-female ratio is nearly equal (0.93), meaning both sexes are almost uniformly affected. Conversely, adult Tuberculosis (TBA) exhibits a clear male predominance, with a ratio of 1.50. This suggests gender-related factors, such as occupational exposures or social behaviors, are more influential in TB transmission among adults than children. This difference highlights the importance of considering social and environmental risk factors when developing targeted prevention strategies for adults.

How does the rate of HIV co-infection differ between children and adults diagnosed with Tuberculosis, and what implications does this have?

Children with Tuberculosis (TBE) had a significantly lower rate of HIV co-infection (24.5%) compared to adults with Tuberculosis (TBA) (44%). This disparity could be attributed to differences in exposure risks and prevalence rates of HIV in the respective age groups. While the lower co-infection rate is better for treatment outcomes it's essential to screen children for HIV if they're diagnosed with TB, and vice versa, to manage both conditions effectively.

In what ways do the types and locations of Tuberculosis vary between children and adults?

While Pulmonary Tuberculosis (TB affecting the lungs) is common in both children and adults, children are more likely to have smear-negative pulmonary TB. Additionally, Extrapulmonary TB (TB occurring outside the lungs) shows variations in location. Lymph node involvement is more frequent among children (30.1%) than adults (12.1%), whereas Pleural TB (TB affecting the lining of the lungs) is more common in adults (51.3%) compared to children (26.2%). The variance of location suggests difference in disease progression between adults and children.

What do the treatment outcomes reveal about how children and adults respond differently to Tuberculosis treatment?

Children with Tuberculosis (TBE) generally experience better treatment outcomes compared to adults with Tuberculosis (TBA). The rate of treatment failure or death is significantly lower in children (1.9%) than in adults (3.9%). This could be due to factors such as differences in immune response, adherence to treatment regimens, or the presence of comorbidities. However, it underscores the importance of tailored treatment approaches to optimize outcomes in both populations.

Why is it important to study the differences between Tuberculosis in children versus adults, like in the Abidjan study?

The study conducted in Abidjan comparing childhood TB (TBE) and adult TB (TBA) is crucial because it highlights the necessity for age-specific strategies in combating Tuberculosis. By understanding the differences in clinical presentation, HIV co-infection rates, and treatment outcomes, healthcare systems can develop more targeted and effective interventions. This includes focusing on early and accurate diagnosis, tailoring treatment regimens, and implementing preventive measures that address the unique needs of children, ultimately reducing the burden of TB and improving the health and well-being of children worldwide.