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

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dc.contributor.author Moore, B.K.
dc.contributor.author Anyalechi, E. Gloria
dc.contributor.author Van Der Walt, M.
dc.contributor.author Smith, S.
dc.contributor.author Erasmus, L.
dc.contributor.author Lancaster, J.
dc.contributor.author Morris, S.
dc.contributor.author Ndjeka, N.
dc.contributor.author Ershova, J.
dc.contributor.author Ismail, Nabila
dc.contributor.author Burton, D.
dc.contributor.author Menzies, H.
dc.date.accessioned 2015-07-13T06:42:20Z
dc.date.available 2015-07-13T06:42:20Z
dc.date.issued 2015-06
dc.description.abstract 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. en_ZA
dc.description.embargo 2015-12-01 en_ZA
dc.description.librarian hb2015 en_ZA
dc.description.sponsorship U.S. Agency for International Development and U.S. Centers for Disease Control and Prevention, with additional support from the South Africa National Institute for Communicable Diseases and the South African Medical Research Council. en_ZA
dc.description.uri http://www.ingentaconnect.comcontent/iuatld/ijtld en_ZA
dc.identifier.citation Moore, BK, Anyalechi, E, Van der Walt, M, Smith, S, Erasmus, L, Lancaster, J, Morris, S, Ndjeka, N, Ershova, J, Ismail, N, Burton, D & Menzies, H 2015, 'Epidemiology of drug-resistant tuberculosis among children and adolescents in South Africa, 2005-2010', International Journal of Tuberculosis and Lung Disease, vol. 19, no. 6, pp. 663-669. en_ZA
dc.identifier.issn 1027-3719 (print)
dc.identifier.issn 1815-7920 (online)
dc.identifier.other 10.5588/ijtld.14.0879
dc.identifier.uri http://hdl.handle.net/2263/47962
dc.language.iso en en_ZA
dc.publisher International Union Against Tuberculosis and Lung Disease en_ZA
dc.rights International Union Against Tuberculosis and Lung Disease en_ZA
dc.subject Drug resistance en_ZA
dc.subject Pediatric en_ZA
dc.subject Cohort review en_ZA
dc.subject Mycobacterium tuberculosis en_ZA
dc.subject South Africa (SA) en_ZA
dc.subject Tuberculosis (TB) en_ZA
dc.title Epidemiology of drug-resistant tuberculosis among children and adolescents in South Africa, 2005-2010 en_ZA
dc.type Postprint Article en_ZA


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