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Open Access Tuberculosis in children treated with second-line drugs under programmatic conditions in Lima, Peru

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OBJECTIVE: To characterise childhood tuberculosis (TB) treated with second-line drugs (SLDs) in Lima, Peru.

DESIGN: Results for the age groups <5 and 5–14 years were compared and treatment outcomes were assessed in cases reported between 2011 and 2015 from six districts of Lima.

RESULTS: Of 96 reported cases, 82 were evaluated. Among these, 59% were boys; the median age was 8 years and 32% were aged <5 years. Contact with a TB case was reported in 82% of cases; 90% were treatment-naïve, 98% had pulmonary localisation and 50% underwent the tuberculin skin test (purified protein derivative), with induration 10 mm in 88%. A positive smear was found in 40%, all in the 5–14 years age group, and 46% were culture-positive. Only 26% had confirmed multidrug-resistant TB, 90% of whom were in the 5–14 years age group. SLDs for confirmed or probable drug-resistant TB (DR-TB) were administered to all cases, with a high proportion of success (over 83%), no failures or deaths and a high proportion of loss to follow-up.

CONCLUSION: The main indication for SLDs in childhood TB was the empirical treatment of DR-TB due to contact with one or more identified DR-TB patients. Bacteriological confirmation was limited; however, treatment success was adequate.
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Keywords: MDR-TB; SLDs; children TB; multidrug-resistant tuberculosis; treatment outcome

Document Type: Research Article

Affiliations: 1: Hospital de Huaycán, Ministerio de Salud, Lima 2: Estrategia Sanitaria Nacional de Prevención y Control de la Tuberculosis, Ministerio de Salud, Lima, Peru 3: Organización Panamerica de Salud, Washington, DC, USA 4: London School of Hygiene & Tropical Medicine, London, UK 5: International Union Against Tuberculosis and Lung Disease, Oslo, Norway 6: Hospital de Emergencias Villa El Salvador, Ministerio de Salud, Lima, Peru

Publication date: November 1, 2018

More about this publication?
  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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