Introduction Tuberculosis (TBC) continues to cause an unacceptably high toll of disease and death among children worldwide, particularly in the developing countries.

Objective Study the epidemiological and clinical aspects of TBC in Tunisian children and clarify its treatment.

Population and methods A descriptive study was carried out, included all cases of TBC diagnosed in Sahloul paediatric unit hospital between 2004 and 2013. Epidemiological, clinical and microbiological data were recorded. Therapeutic and evolutionary aspects were clarified.

Results We reviewed 32 cases (16 boys and 16 girls), aged from 6 months to 15 years. All patients were vaccinated against tuberculosis. No case of malnutrition none immune deficiency had been recorded until the first hospitalisation. The diagnosis of TBC was based on clinical features, tuberculin skin test, chest radiography and the histological examination of lymph node, peritoneal and pleural biopsy. Diagnoses were identified: Lymph node tuberculosis (11 cases), pulmonary tuberculosis (4 cases), peritoneal tuberculosis (4 cases), bone tuberculosis (4 cases), tuberculous meningitis (2 cases), cutaneous tuberculosis (1 case), renal tuberculosis (1 case), tuberculosis in hematopoietic stem cell (1 case), pleuro-pericarditis tuberculosis (1 case), and the disease has affected several organs (disseminated) in 3 cases. Two cases of congenital immunodeficiency syndrome were identified. All our patients were treated with an association of Isoniazid, Rifampicin, Pyrazinamide and Ethambutol for 2 months, and then they received Isoniazid and Rifampicin for a period ranging from 2 to 16 months. 27 children were cured (24 without sequelae and 3 with sequelae). Two children died.

Conclusion Tuberculosis in children presents particularly difficult challenges, but advances in paediatric tuberculosis research could provide wider insights and opportunities for tuberculosis control especially in developing countries.