Unani Perspective of Pediatric Tuberculosis (Sil): Classical Management and Supportive Strategies for Att-Induced Adverse Effects

Mycobacterium tuberculosis, the cause of tuberculosis (TB), continues to be a serious worldwide health concern, especially for children in high-burden nations. Due to its paucibacillary origin, ambiguous clinical presentation, and challenges with microbiological confirmation, paediatric tuberculosis is frequently underdiagnosed. The risk of illness progression and mortality in children is greatly increased by immunosuppression, malnutrition, low socioeconomic situations, and intimate household exposure. Furthermore, side effects such gastrointestinal problems, hepatotoxicity, arthralgia, hypersensitivity reactions, and influenza-like symptoms are often linked to extended anti-tubercular therapy (ATT). According to the Unani medical system, tuberculosis is referred to as Sil or Diq, a chronic wasting condition brought on by abnormal heat (Hararat-e-Ghariba), depletion of body moisture (Rutoobat-e-Tabayee), distortion of temperament (Su-e-Mizaj), and weakness of vital organs (Aaza-e-Asliya). Its aetiology, pathophysiology, clinical symptoms and therapy were thoroughly discussed by classical Unani scholars such as Razi, Ibn Sina, Jurjani and Majoosi. In order to restore humoral balance, boost immunity, and enhance overall health, Unani management places a strong emphasis on Ilaj bil Ghiza (dietotherapy), Ilaj bil Tadbeer (regimental therapy) and Ilaj bil Dawa (pharmacotherapy). The traditional Unani view of paediatric tuberculosis and supportive Unani methods for the treatment of ATT-induced side effects are highlighted in this paper. Treatment tolerance, nutritional status, and quality of life in children taking ATT may be improved by Unani therapies targeting Taqwiyat-e-Meda (gastric strengthening), Hifz-e-Kabid (hepatoprotection), Taskeen-e-Alam (pain relief) and enhancement of Quwwat-e-Mudabbira-e-Badan. The review also highlights the necessity of more evidence-based research to support the use of Unani medicine as a supportive treatment for pediatric tuberculosis.