Skip directly to site content Skip directly to page options Skip directly to A-Z link Skip directly to A-Z link Skip directly to A-Z link
Volume 23, Number 11—November 2017
Research

Drug-Resistant Tuberculosis among Children, China, 2006–2015

Ning-ning Tao, Xiao-chun He, Xian-xin Zhang, Yao Liu, Chun-bao Yu, and Huai-chen LiComments to Author 
Author affiliations: Shandong Provincial Hospital affiliated to Shandong University, Jinan, China (N.-N. Tao, Y. Liu, H.-C. Li); Baoji Central Hospital, Baoji, China (X.-C. He); Shandong Provincial Chest Hospital, Jinan (X.-X. Zhang, C.-B. Yu)

Main Article

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.

Main Article

References
  1. 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
  2. World Health Organization. Global tuberculosis report 2016. Geneva: The Organization; 2016. WHO/HTM/TB/2016.13.
  3. 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.
  4. 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.
  5. 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
  6. 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
  7. 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
  8. 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
  9. Swaminathan  S, Rekha  B. Pediatric tuberculosis: global overview and challenges. Clin Infect Dis. 2010;50(Suppl 3):S184–94. DOIPubMedGoogle Scholar
  10. 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
  11. Marais  BJ, Pai  M. Recent advances in the diagnosis of childhood tuberculosis. Arch Dis Child. 2007;92:446–52. DOIPubMedGoogle Scholar
  12. 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
  13. Seddon  JA, Shingadia  D. Epidemiology and disease burden of tuberculosis in children: a global perspective. Infect Drug Resist. 2014;7:153–165.
  14. Loebstein  R, Koren  G. Clinical pharmacology and therapeutic drug monitoring in neonates and children. Pediatr Rev. 1998;19:423–8.PubMedGoogle Scholar
  15. 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.
  16. 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
  17. World Health Organization. Guidelines for surveillance of drug resistance in tuberculosis. 5th ed. Geneva: The Organization; 2015. WHO/HTM/TB/2015.13.
  18. World Health Organization. Recommendations for investigating contacts of persons with infectious tuberculosis in low- and middle-income countries. Geneva: The Organization; 2012.
  19. SPSS Inc. SPSS 17.0 Integrated Student Version. London: Pearson Education. 2009;49:397–400.
  20. 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
  21. Brent  AJ. Childhood TB surveillance: bridging the knowledge gap to inform policy. J Trop Med. 2012; 2012:865436.
  22. Perez-Velez  CM, Marais  BJ. Tuberculosis in children. N Engl J Med. 2012;367:348–61. DOIPubMedGoogle Scholar
  23. 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
  24. 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
  25. 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
  26. 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.
  27. 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
  28. 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
  29. Sadikot  RT. Identifying patients at high risk of tuberculosis recurrence. Int J Mycobacteriol. 2016;5(Suppl 1):S66. DOIPubMedGoogle Scholar
  30. 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
  31. 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
  32. 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
  33. 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
  34. World Health Organization. Roadmap for childhood tuberculosis: towards zero deaths. Geneva: The Organization; 2013.

Main Article

Page created: October 16, 2017
Page updated: October 16, 2017
Page reviewed: October 16, 2017
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
file_external