Tuberculosis (NICE clinical guideline 33)

The UK has one of the highest rates of tuberculosis (TB) in Western Europe.1 If current trends continue, with over 7500 cases per year,2 England will overtake the whole of the USA in the annual number of TB notifications within the next 2 years.3 TB disease in UK children is relatively rare with <5% cases affecting patients under the age of 15 years.2 Outside large conurbations, most paediatricians will see very few children with TB. However, the risk of progression from latent TB to TB disease and of TB meningitis or miliary TB is much higher in children, especially those under the age of 2 years.4 It is, therefore, important that paediatricians recognise children at risk of TB disease and the symptoms and signs with which they present. This article summarises the recently updated National Institute for Health and Care Excellence (NICE) guideline ‘Tuberculosis’ (NG33)5 ,6 published in 2016 (box 1). Several areas of this guideline are controversial and we will highlight these. Box 1 ### Resources National Institute for Health and Care Excellence (NICE) guideline—NG33 Tuberculosis https://www.nice.org.uk/guidance/NG33 Collaborative TB Strategy, Public Health England https://www.gov.uk/government/publications/collaborative-tuberculosis-strategy-for-england Information for the public (NICE) https://www.nice.org.uk/guidance/ng33/ifp/chapter/Tuberculosis Key recommendations in the updated guideline: Box 2 ### Glossary of terms Mycobacterium tuberculosis complex (MTB complex)—A genetically related group of mycobacteria that can cause TB disease in …