Epidemiology of drug-resistant tuberculosis among children and adolescents in South Africa, 2005–2010

Details

• Alternative Title:
  Int J Tuberc Lung Dis
• Personal Author:
  Moore, B. K. ; Anyalechi, E. ; van der Walt, M. ; Smith, S. ; Erasmus, L. ; Lancaster, J. ; Morris, S. ; Ndjeka, N. ; Ershova, J. ; Ismail, N. ; Burton, D. ; Menzies, H.
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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.
• Keywords:
  • South Africa
  • drug resistance
  • pediatric
  • cohort review
  • Mycobacterium tuberculosis
  • Adolescent
  • Age Distribution
  • Age Factors
  • Anti-HIV Agents
  • Antitubercular Agents
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• Source:
  Int J Tuberc Lung Dis. 19(6):663-669
• Pubmed ID:
  25946356
• Pubmed Central ID:
  PMC4886335
• Document Type:
  Journal Article
• Funding:
  CC999999/Intramural CDC HHSUnited States/
• Volume:
  19
• Issue:
  6
• Download URL:
  https://stacks.cdc.gov/view/cdc/39776/cdc_39776_DS1.pdf
• File Type:
  [PDF - 153.06 KB]
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:80d3957ab3071afc04aa2c17c58a9751a49f2d6d71d4efa6e5bb24e6626994fa