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Epidemiology of drug-resistant tuberculosis among children and adolescents in South Africa, 2005–2010
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6 2015
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Source: Int J Tuberc Lung Dis. 19(6):663-669
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Details:
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Alternative Title:Int J Tuberc Lung Dis
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Personal Author:
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Description:OBJECTIVE
To describe the demographic and clinical characteristics of children and adolescents diagnosed with resistance to any anti-tuberculosis drug (drug-resistant tuberculosis; DR-TB) in South Africa.
DESIGN
We retrospectively reviewed medical records of all children (<13 years) and adolescents (13 to <18 years) with DR-TB at specialty hospitals in four South African provinces from 2005 to 2010.
RESULTS
During the review period, 774 children and adolescents (median age 11.3 years) were diagnosed with DR-TB at selected facilities. A high proportion of patients had a history of previous TB treatment (285/631; 45.2%), human immunodeficiency virus (HIV) infection (375/685; 54.7%), contact with a TB case (347/454; 76.4%), and smear-positive (443/729; 60.8%), cavitary (253/680, 38.7%) disease. Eighty-two per cent of patients with HIV infection received antiretroviral therapy. Of 626 patients diagnosed with multidrug-resistant TB (MDR-TB), 561 (89.6%) received a regimen consistent with national guidelines; the median length of treatment was 22 months (IQR 16–25). Among 400 patients with any DR-TB and a known outcome, 20.3% died during treatment.
CONCLUSION
Pediatric DR-TB in these provinces is characterized by complex clinical features at diagnosis, with one in five children dying during treatment. History of previous treatment and contact with a TB patient indicate opportunities for earlier diagnosis and treatment to improve outcomes.
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Pubmed ID:25946356
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Pubmed Central ID:PMC4886335
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Volume:19
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Issue:6
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