Tuberculosis in children treated with second-line drugs under programmatic conditions 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.
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
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