i
Epidemiology of pediatric multidrug-resistant tuberculosis in the United States, 1993–2014
-
Oct 16 2017
-
-
Source: Clin Infect Dis. 65(9):1437-1443.
[PDF-163.23 KB]
Details:
-
Alternative Title:Clin Infect Dis
-
Personal Author:
-
Description:Background
Multidrug-resistant tuberculosis (MDR TB) is an important global public health threat, but accurate estimates of MDR TB burden among children are lacking.
Methods
We analyzed demographic, clinical and laboratory data for newly-diagnosed pediatric (<15 years) TB cases reported to the US National TB Surveillance System (NTSS) during 1993–2014. MDR TB was defined as culture-confirmed TB disease with resistance to at least isoniazid and rifampicin. To ascertain potential under-estimation of pediatric MDR TB, we surveyed high burden states for clinically-diagnosed cases treated for MDR TB.
Results
Of 20,789 pediatric TB cases, 5,162 (24.8%) had bacteriologically-confirmed TB. Among 4,862 (94.2%) with drug-susceptibility testing, 82 (1.7%) had MDR TB. Most pediatric MDR TB cases were female (n=51, 62%), median age was 5 years (IQR 1–12), one-third were Hispanic (n=28, 34%), and two-thirds (n=55, 67%) were born in the US. Most cases had additional resistance to ≥1 other first-line drug (n=66; 80.5%) and one-third had resistance to ≥1 second-line drug (24/73 tested). Of 77 who started treatment prior to 2013, 66 (86%) completed treatment and 4 (5%) died. Among the four high TB burden states/jurisdictions surveyed, there was 42–55% under-estimation of pediatric MDR TB cases when using only culture-confirmed case definitions.
Conclusions
Only one-quarter of pediatric TB cases had culture-confirmed TB, likely resulting in underestimation of true pediatric MDR TB burden in the US using strictly bacteriologic criteria. Better estimates of pediatric MDR TB burden in the US are needed and should include clinical diagnoses based on epidemiologic criteria.
-
Subjects:
-
Source:
-
Pubmed ID:28633501
-
Pubmed Central ID:PMC5801661
-
Document Type:
-
Funding:
-
Place as Subject:
-
Collection(s):
-
Main Document Checksum:
-
Download URL:
-
File Type:
