Volume 23, Number 11—November 2017
Research
Drug-Resistant Tuberculosis among Children, China, 2006–2015
Table 1
Sociodemographic and clinical characteristics of child and adult TB patients, Shandong Province, China, 2006–2015*
Characteristics | Age <18 y, no. (%), n = 784 | Age >18 y, no. (%), n = 13,439 | Total OR (95% CI), n = 14,223 | p value | |
---|---|---|---|---|---|
Male sex | 458 (58.42) | 10,078 (74.99) | 2.134 (1.842–2.437) | <0.001 | |
Extrapulmonary TB | 154/784 (19.64) | 2,274/13,439 (16.92) | 0.833 (0.695–0.999) | 0.05 | |
TB contact† | 39/784 (4.97) | 396/13,134 (3.02) | 0.594 (0.424–0.832) | 0.002 | |
Chest radiology | |||||
Cavitary pulmonary disease | 220/779 (28.24) | 4,683/13,334 (35.12) | 1.375 (1.172–1.614) | <0.001 | |
Bilateral disease‡ | 218/401 (54.36) | 2,929/5,051 (57.99) | 1.159 (0.945–1.421) | 0.16 |
*OR, odds ratio; TB, tuberculosis.
†Contact with family members or schoolmates with TB long enough for long-term exposure (18).
‡Bilateral lesions such as “tree-in-bud,” bronchiectasis, cavitary pulmonary disease, and other inflammation signs seen on radiologic images.
References
- Cegielski JP, Dalton T, Yagui M, Wattanaamornkiet W, Volchenkov GV, Via LE, et al.; Global Preserving Effective TB Treatment Study (PETTS) Investigators. Extensive drug resistance acquired during treatment of multidrug-resistant tuberculosis. Clin Infect Dis. 2014;59:1049–63. DOIPubMedGoogle Scholar
- World Health Organization. Global tuberculosis report 2016. Geneva: The Organization; 2016. WHO/HTM/TB/2016.13.
- World Health Organization. Guidance for national tuberculosis programmes on the management of tuberculosis in children. Geneva: The Organization; 2006. WHO/HTM/ TB/2006.371;WHO/FCH/CAH/2006.7.
- World Health Organization. Guidance for national tuberculosis programmes on the management of tuberculosis in children. 2nd ed. Geneva: The Organization; 2014. WHO/HTM/TB/2014.03.
- Dodd PJ, Gardiner E, Coghlan R, Seddon JA. Burden of childhood tuberculosis in 22 high-burden countries: a mathematical modelling study. Lancet Glob Health. 2014;2:e453–9. DOIPubMedGoogle Scholar
- Zignol M, Sismanidis C, Falzon D, Glaziou P, Dara M, Floyd K. Multidrug-resistant tuberculosis in children: evidence from global surveillance. Eur Respir J. 2013;42:701–7. DOIPubMedGoogle Scholar
- Seddon JA, Hesseling AC, Willemse M, Donald PR, Schaaf HS. Culture-confirmed multidrug-resistant tuberculosis in children: clinical features, treatment, and outcome. Clin Infect Dis. 2012;54:157–66. DOIPubMedGoogle Scholar
- du Preez K, Schaaf HS, Dunbar R, Swartz A, Bissell K, Enarson DA, et al. Incomplete registration and reporting of culture-confirmed childhood tuberculosis diagnosed in hospital. Public Health Action. 2011;1:19–24. DOIPubMedGoogle Scholar
- Swaminathan S, Rekha B. Pediatric tuberculosis: global overview and challenges. Clin Infect Dis. 2010;50(Suppl 3):S184–94. DOIPubMedGoogle Scholar
- Marais BJ, Gie RP, Schaaf HS, Beyers N, Donald PR, Starke JR. Childhood pulmonary tuberculosis: old wisdom and new challenges. Am J Respir Crit Care Med. 2006;173:1078–90. DOIPubMedGoogle Scholar
- Marais BJ, Pai M. Recent advances in the diagnosis of childhood tuberculosis. Arch Dis Child. 2007;92:446–52. DOIPubMedGoogle Scholar
- Schaaf HS, Shean K, Donald PR. Culture confirmed multidrug resistant tuberculosis: diagnostic delay, clinical features, and outcome. Arch Dis Child. 2003;88:1106–11. DOIPubMedGoogle Scholar
- Seddon JA, Shingadia D. Epidemiology and disease burden of tuberculosis in children: a global perspective. Infect Drug Resist. 2014;7:153–165.
- Loebstein R, Koren G. Clinical pharmacology and therapeutic drug monitoring in neonates and children. Pediatr Rev. 1998;19:423–8.PubMedGoogle Scholar
- Guo Q, Pan Y, Yang Z, Liu R, Xing L, Peng Z, et al. Epidemiology and clinical characteristics of pediatric drug-resistant tuberculosis in Chongqing, China. PLoS One. 2016;11:e0151303.
- Zhao Y, Xu S, Wang L, Chin DP, Wang S, Jiang G, et al. National survey of drug-resistant tuberculosis in China. N Engl J Med. 2012;366:2161–70. DOIPubMedGoogle Scholar
- World Health Organization. Guidelines for surveillance of drug resistance in tuberculosis. 5th ed. Geneva: The Organization; 2015. WHO/HTM/TB/2015.13.
- World Health Organization. Recommendations for investigating contacts of persons with infectious tuberculosis in low- and middle-income countries. Geneva: The Organization; 2012.
- SPSS Inc. SPSS 17.0 Integrated Student Version. London: Pearson Education. 2009;49:397–400.
- Jenkins HE, Tolman AW, Yuen CM, Parr JB, Keshavjee S, Pérez-Vélez CM, et al. Incidence of multidrug-resistant tuberculosis disease in children: systematic review and global estimates. Lancet. 2014;383:1572–9. DOIPubMedGoogle Scholar
- Brent AJ. Childhood TB surveillance: bridging the knowledge gap to inform policy. J Trop Med. 2012; 2012:865436.
- Perez-Velez CM, Marais BJ. Tuberculosis in children. N Engl J Med. 2012;367:348–61. DOIPubMedGoogle Scholar
- Schaaf HS, Marais BJ, Hesseling AC, Brittle W, Donald PR. Surveillance of antituberculosis drug resistance among children from the Western Cape Province of South Africa—an upward trend. Am J Public Health. 2009;99:1486–90. DOIPubMedGoogle Scholar
- Diandé S, Sangaré L, Kouanda S, Dingtoumda BI, Mourfou A, Ouédraogo F, et al. Risk factors for multidrug-resistant tuberculosis in four centers in Burkina Faso, West Africa. Microb Drug Resist. 2009;15:217–21. DOIPubMedGoogle Scholar
- Brewer TF, Choi HW, Seas C, Krapp F, Zamudio C, Shah L, et al. Self-reported risks for multiple-drug resistance among new tuberculosis cases: implications for drug susceptibility screening and treatment. PLoS One. 2011;6:e25861. DOIPubMedGoogle Scholar
- Taneja R, Garcia-Prats AJ, Furin J, Maheshwari HK. Pediatric formulations of second-line anti-tuberculosis medications: challenges and considerations. Int J Tuberc Lung Dis. 2015;19:Supple1:61–8.
- Seddon JA, Hesseling AC, Marais BJ, McIlleron H, Peloquin CA, Donald PR, et al. Pediatric use of second-line anti-tuberculosis agents. Rev Tuberc (Edinb). 2012;92:9–17. DOIGoogle Scholar
- Moore BK, Anyalechi E, van der Walt M, Smith S, Erasmus L, Lancaster J, et al. Epidemiology of drug-resistant tuberculosis among children and adolescents in South Africa, 2005-2010. Int J Tuberc Lung Dis. 2015;19:663–9. DOIPubMedGoogle Scholar
- Sadikot RT. Identifying patients at high risk of tuberculosis recurrence. Int J Mycobacteriol. 2016;5(Suppl 1):S66. DOIPubMedGoogle Scholar
- Galli L, Lancella L, Tersigni C, Venturini E, Chiappini E, Bergamini BM, et al. Pediatric tuberculosis in Italian children: epidemiological and clinical data from the Italian Register of Pediatric Tuberculosis. Int J Mol Sci. 2016;17:E960. DOIPubMedGoogle Scholar
- Mabunda TE, Ramalivhana NJ, Dambisya YM. Mortality associated with tuberculosis/HIV co-infection among patients on TB treatment in the Limpopo province, South Africa. Afr Health Sci. 2014;14:849–54. DOIPubMedGoogle Scholar
- Acuña-Villaorduña C, Ayakaka I, Dryden-Peterson S, Nakubulwa S, Worodria W, Reilly N, et al. High mortality associated with retreatment of tuberculosis in a clinic in Kampala, Uganda: a retrospective study. Am J Trop Med Hyg. 2015;93:73–5. DOIPubMedGoogle Scholar
- Liew SM, Khoo EM, Ho BK, Lee YK, Mimi O, Fazlina MY, et al. Tuberculosis in Malaysia: predictors of treatment outcomes in a national registry. Int J Tuberc Lung Dis. 2015;19:764–71. DOIPubMedGoogle Scholar
- World Health Organization. Roadmap for childhood tuberculosis: towards zero deaths. Geneva: The Organization; 2013.