Journal of Clinical Tuberculosis and Other Mycobacterial Diseases最新文献

{"title":"Survival status and risk factors for mortality among multidrug-resistant tuberculosis patients in Addis Ababa, Ethiopia: A retrospective follow-up study","authors":"Genanew Kassie Getahun ,&nbsp;Elias Gezahegn ,&nbsp;Getabalew Endazenawe ,&nbsp;Tewodros Shitemaw ,&nbsp;Zelalem Negash ,&nbsp;Samuel Dessu","doi":"10.1016/j.jctube.2023.100398","DOIUrl":"10.1016/j.jctube.2023.100398","url":null,"abstract":"<div><h3>Background</h3><p>Tuberculosis continues to be a major health concern around the world. It kills an estimated 1.6 million people each year. The World Health Organization (WHO) removed Ethiopia from its list of thirty countries having a high prevalence of MDR/RR-TB in 2021. As a result, the aim of this study was to assess the current context of survival status and risk factors of multidrug-resistant tuberculosis patients in Addis Ababa, Ethiopia, in 2022.</p></div><div><h3>Methods</h3><p>An institutional-based retrospective cohort study with 245 patients was undertaken using multidrug-resistant tuberculosis patients who were recruited from January 1st, 2018 to December 30th, 2021, in St. Peter's specialized hospital. To find independent predictors of survival status, Cox regression analysis was used. An adjusted hazard ratio with a 95% confidence interval and a p-value of &lt; 0.05 was used to establish association and statistical significance.</p></div><div><h3>Results</h3><p>The result of the study revealed that the incidence of mortality in this study was 13.1% (95% CI: 10.3–16.5). Moreover, being male (AOR = 3.7: 95% CI = 1.2, 11.4), old age (AOR = 14: 95% CI = 3.0, 60.4), site of TB (AOR = 0.2: 95% CI = 0.03, 0.6), and presence of comorbidity (AOR = 9.2: 95% CI = 2.4, 35.3), were independent predictors of time to death.</p></div><div><h3>Conclusion</h3><p>Generally, the death rate among research participants was high. Moreover, male gender, old age, site of tuberculosis, and presence of other comorbidity were predictors of mortality among MDR-TB patients.</p></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"33 ","pages":"Article 100398"},"PeriodicalIF":2.0,"publicationDate":"2023-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/31/2d/main.PMC10520522.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41147192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A cluster of six respiratory cultures positive for Mycobacterium xenopi –Clinical characteristics and genomic characterization","authors":"Kendall Kling ,&nbsp;Rebecca Osborn ,&nbsp;Adil Menon ,&nbsp;Janna Williams ,&nbsp;Ryan Cardew ,&nbsp;Omar Al-Heeti ,&nbsp;Phillip Santoiemma ,&nbsp;Michael Angarone ,&nbsp;Samuel Gatesy ,&nbsp;Travis Kochan ,&nbsp;Teresa Zembower ,&nbsp;Karen Krueger ,&nbsp;Egon A. Ozer ,&nbsp;Chao Qi","doi":"10.1016/j.jctube.2023.100397","DOIUrl":"https://doi.org/10.1016/j.jctube.2023.100397","url":null,"abstract":"<div><p><em>Mycobacterium xenopi</em> is a slow growing non-tuberculous mycobacterium (NTM) isolated from water systems and has been associated with pseudo-outbreaks and pulmonary infections in humans. We observed a cluster of six respiratory cultures positive for <em>M. xenopi</em> within a six-month period at our institution, approximately double our normal isolation rate of this organism. Only three of the six cases met clinical, radiographic, and microbiologic criteria for NTM infection. An investigation led by our hospital’s Healthcare Epidemiology and Infection Program found no epidemiologic link between the six patients. Three isolates underwent whole-genome sequencing (WGS) and phylogenetic analysis confirmed they were non-clonal. <em>In vitro</em> susceptibility data found the isolates were sensitive to macrolides, moxifloxacin, and rifabutin. Our findings suggest that isolation of <em>M. xenopi</em> from pulmonary specimens may be increasing, further defines the genomic population structure of this potentially emerging infection, and establishes WGS as a useful tool for outbreak investigation strain typing.</p></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"33 ","pages":"Article 100397"},"PeriodicalIF":2.0,"publicationDate":"2023-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50172898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pulmonary tuberculosis complicated by pneumothorax, and acute respiratory distress syndrome (ARDS) in the settings of advanced HIV disease: A case report","authors":"Haba Haile ,&nbsp;Lijalem Tema ,&nbsp;Assegid Anjulo ,&nbsp;Zelalem Temesgen ,&nbsp;Degu Jerene","doi":"10.1016/j.jctube.2023.100396","DOIUrl":"10.1016/j.jctube.2023.100396","url":null,"abstract":"<div><h3>Introduction</h3><p>A large proportion of the global burden of HIV-associated TB occurs in sub-Saharan Africa; including 74% of new cases of TB and 79% of deaths occurs in this area. Spontaneous pneumothorax occurs more frequently in patients with AIDS than the general population with the estimated incidence to be about 2–5% of overall total cases. Tuberculosis ARDS and septic shock are rare but carries extremely poor prognosis.</p></div><div><h3>Case summary</h3><p>A 27 year old male with advanced HIV disease with very low CD4 count presented to Wolaita Sodo University comprehensive specialized hospital, Ethiopia on July 6, 2023. The patient diagnosed with spontaneous pneumothorax secondary to drug susceptible tuberculosis after positive urine LF-LAM and sputum gene expert. He was intubated after emergency tube thoracostomy, and subsequently treated with anti-TB, corticosteroid, broad-spectrum IV antibiotics and high dose cotrimoxazole. The patient developed ARDS due to possible tuberculosis related septic shock and died of multi-organ failure.</p></div><div><h3>Discussion</h3><p>Spontaneous pneumothorax in the setting of HIV raises concern for PCP, though in this case it could be secondary to TB. Tuberculosis related ARDS and septic shock are rare complication but carries poor prognosis especially in setting of AHD. We had limited experience and difficulties in the management of patient with persistent pneumothorax with the concomitant ARDS requiring lung protective management, and this part remain the future area of scientific research.</p></div><div><h3>Conclusion</h3><p>In patients with advanced HIV disease, who present with signs of respiratory failure, the likelihood of spontaneous pneumothorax, TB-ARDS and septic shock should be anticipated in the differential diagnosis and optimal management plan should be designed.</p></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"33 ","pages":"Article 100396"},"PeriodicalIF":2.0,"publicationDate":"2023-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e3/89/main.PMC10509693.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41166419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic value of the neutrophil lymphocyte ratio in discrimination between tuberculosis and bacterial community acquired pneumonia: A meta-analysis","authors":"Horieh Shojaan ,&nbsp;Niusha Kalami ,&nbsp;Masoumeh Ghasempour Alamdari ,&nbsp;Seyed Matin Emami Alorizy ,&nbsp;Arshin Ghaedi ,&nbsp;Aida Bazrgar ,&nbsp;Monireh Khanzadeh ,&nbsp;Brandon Lucke-Wold ,&nbsp;Shokoufeh Khanzadeh","doi":"10.1016/j.jctube.2023.100395","DOIUrl":"https://doi.org/10.1016/j.jctube.2023.100395","url":null,"abstract":"<div><h3>Background</h3><p>We conducted a systematic review and <em>meta</em>-analysis, based on Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines, to evaluate current literature on diagnostic value of neutrophil to lymphocyte ratio (NLR) in discrimination between tuberculosis (TB) and bacterial community acquired pneumonia (B-CAP).</p></div><div><h3>Methods</h3><p>Literature search was conducted from July 20, 2023 using<!--> <!-->Scopus, PubMed,<!--> <!-->and Web of Science databases. STATA software (version 12.0; Stata Corporation) was used for all analyses.</p></div><div><h3>Results</h3><p>We found that patients with TB had significantly lower levels of NLR compared to those with B-CAP (SMD = −1.09, 95 %CI = −1.78- −0.40, P = 0.002). In the quality subgroup analysis, we found that patients with TB had significantly lower level of NLR compared to those with B-CAP consistent in moderate (SMD = -0.86, 95 %CI = −2.30, 0.57, P = 0.23) and high-quality studies (SMD = -1.25, 95 %CI = -2.07, −0.42). In the subgroup analysis based on continent, we found that patients with TB had significantly lower level of NLR compared to those with B-CAP in studies performed in Asian populations (SMD = -1.37, 95 %CI = −2.13, −0.61, P &lt; 0.001), but not on African population (SMD = -0.02, 95 %CI = −1.06, 1.02, P = 0.97). The result of this study did not change after execution of sensitivity analysis. The pooled sensitivity of NLR was 0.86 (95% CI = 0.80, 0.91), and the pooled specificity was0.88 (95% CI = 0.69, 0.95).</p></div><div><h3>Conclusion</h3><p>Patients with TB had a significantly lower NLR levels compared to those with B-CAP, so we utilized this biomarker for distinguishing between the disorders.</p></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"33 ","pages":"Article 100395"},"PeriodicalIF":2.0,"publicationDate":"2023-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50172899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Universal drug-susceptibility testing of first-line drugs to preserve their efficacy: An essential strategy to defeat tuberculosis","authors":"Madhur Dev Bhattarai","doi":"10.1016/j.jctube.2023.100394","DOIUrl":"10.1016/j.jctube.2023.100394","url":null,"abstract":"","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"33 ","pages":"Article 100394"},"PeriodicalIF":2.0,"publicationDate":"2023-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/86/56/main.PMC10475499.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10166944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Challenging diagnosis of Mycolicibacterium cosmeticum/canariasense infection: A case report and literature review","authors":"Daniel Grupel ,&nbsp;Orly Sagi ,&nbsp;Israel Nissan ,&nbsp;Rona Grossman ,&nbsp;Motro Yair ,&nbsp;Jacob Moran-Gilad ,&nbsp;Dana Danino","doi":"10.1016/j.jctube.2023.100393","DOIUrl":"https://doi.org/10.1016/j.jctube.2023.100393","url":null,"abstract":"<div><p>We present the case of an immunocompromised child with <em>Mycolicibacterium cosmeticum/ canariasense</em> infection. Our case highlights the difficulty in adequate speciation. Most isolates described in the literature were identified using 16 s-<em>rRNA</em> PCR, which if performed on our sample would at best be inconclusive. Misidentifications could have a real impact on the body of evidence collected on these isolates thus far.</p></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"33 ","pages":"Article 100393"},"PeriodicalIF":2.0,"publicationDate":"2023-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50172900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship between patient sex and anatomical sites of extrapulmonary tuberculosis in Mali","authors":"Bocar Baya ,&nbsp;Ibrahim Sanogo ,&nbsp;Mahamadou Kone ,&nbsp;Dianguina Soumare ,&nbsp;Kadidia Ouattara ,&nbsp;Amadou Somboro ,&nbsp;Mamadou Wague ,&nbsp;Nadie Coulibaly ,&nbsp;Isaac Koloma ,&nbsp;Mariam Coulibaly ,&nbsp;Mohamed Nantoume ,&nbsp;Mamadou Perou ,&nbsp;Kadidia Kone ,&nbsp;Djeneba Coulibaly ,&nbsp;Hawa Boukary Diarra ,&nbsp;Bourahima Kone ,&nbsp;Ayouba Diarra ,&nbsp;Mamadou D. Coulibaly ,&nbsp;Moumine Sanogo ,&nbsp;Bassirou Diarra ,&nbsp;Djeneba Dabitao","doi":"10.1016/j.jctube.2023.100389","DOIUrl":"10.1016/j.jctube.2023.100389","url":null,"abstract":"<div><h3>Background</h3><p>Contribution of host factors in mediating susceptibility to extrapulmonary tuberculosis is not well understood.</p></div><div><h3>Objective</h3><p>To examine the influence of patient sex on anatomical localization of extrapulmonary tuberculosis.</p></div><div><h3>Methods</h3><p>We conducted a retrospective cross-sectional study in Mali, West Africa. Hospital records of 1,304 suspected cases of extrapulmonary tuberculosis, available in TB Registry of a tertiary tuberculosis referral center from 2019 to 2021, were examined.</p></div><div><h3>Results</h3><p>A total of 1,012 (77.6%) were confirmed to have extrapulmonary tuberculosis with a male to female ratio of 1.59:1. Four clinical forms of EPTB predominated, namely pleural (40.4%), osteoarticular (29.8%), lymph node (12.5%), and abdominal TB (10.3%). We found sex-based differences in anatomical localization of extrapulmonary tuberculosis, with males more likely than females to have pleural TB (OR: 1.51; 95% CI [1.16 to 1.98]). Conversely, being male was associated with 43% and 41% lower odds of having lymph node and abdominal TB, respectively (OR: 0.57 and 0.59).</p></div><div><h3>Conclusion</h3><p>Anatomical sites of extrapulmonary tuberculosis differ by sex with pleural TB being associated with male sex while lymph node and abdominal TB are predominately associated with female sex. Future studies are warranted to understand the role of sex in mediating anatomical site preference of tuberculosis.</p></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"33 ","pages":"Article 100389"},"PeriodicalIF":2.0,"publicationDate":"2023-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/2d/ef/main.PMC10448223.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10164521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Morbidity and mortality in tuberculosis associated immune reconstitution inflammatory syndrome in children living with HIV: A narrative review","authors":"Haslina Hashim","doi":"10.1016/j.jctube.2023.100392","DOIUrl":"10.1016/j.jctube.2023.100392","url":null,"abstract":"<div><p>Tuberculosis-associated immune reconstitution syndrome (TB-IRIS) is an increasingly recognized complication of children living with HIV who are receiving treatment for active tuberculosis (TB). The purpose of the study was to appraise available evidence of morbidity and mortality related to TB IRIS among the paediatric population. A non-systematic review of the literature was conducted by retrieving records from Scopus, PubMed and Google Scholar). Four specific research questions assessing the risk factors (age, undernutrition, extrapulmonary TB and degree of immunosuppression) for TB-IRIS were discussed. The search yielded 370 articles, subsequently screened for eligibility according to the inclusion criteria. The majority of the articles were adult studies. Six studies were identified: Three retrospective and three prospective studies. The majority of the studies were conducted in TB/HIV-endemic countries. Only one study addressed mortality due to TB-IRIS as an outcome. A total of 6 mortalities related to TB-IRIS were reported. Advanced immunosuppression is universally agreed as an established risk factor for mortality in TB-IRIS in children. The severe presentation was more common in children with extrapulmonary tuberculosis. There is a paucity of data available on mortality in HIV-infected children with TB-IRIS. Future research is needed to assess the predictive factors of morbidity and mortality in HIV-infected children with TB-IRIS especially in low resource and high endemic countries.</p></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"33 ","pages":"Article 100392"},"PeriodicalIF":2.0,"publicationDate":"2023-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/3e/62/main.PMC10448151.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10164520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical features, resistance patterns and treatment outcomes of drug-resistant extra-pulmonary tuberculosis: A scoping review","authors":"Emmanuel Miiro ,&nbsp;Ronald Olum ,&nbsp;Joseph Baruch Baluku","doi":"10.1016/j.jctube.2023.100390","DOIUrl":"10.1016/j.jctube.2023.100390","url":null,"abstract":"<div><h3>Background</h3><p>Drug-resistant tuberculosis (DR-TB) is a threat to tuberculosis (TB) control. Extra-pulmonary forms of DR-TB (DR-epTB) are not well characterized. This review summarizes the clinical features, resistance patterns and treatment outcomes of DR-epTB.</p></div><div><h3>Methods</h3><p>We searched EMBASE to identify studies that reported drug-resistance among extra-pulmonary TB sites. All age groups were included in this review. Studies which did not describe drug-resistance patterns at extra-pulmonary TB sites were excluded. We summarized the proportion of resistance to individual anti-TB drugs as well as multi-drug resistant (MDR), pre-extensively drug resistant (pre-XDR) and extensively drug-resistant (XDR) TB.</p></div><div><h3>Results</h3><p>Eighteen studies with a total of 10,222 patients with extra-pulmonary TB of whom 1,236 (12.0%) had DR-epTB, were included in this review. DR-epTB was mostly reported in young people aged 28 to 46 years. While TB meningitis is the most commonly studied form, adenitis is the commonest form of DR-epTB reported in 21% to 47%. Central nervous system TB (3.8% to 51.6%), pleural TB (11.3% to 25.9%), skeletal TB (9.4% to 18.1%), abdominal TB (4.3% to 6.5%), and disseminated TB (3.8%) are also encountered. The HIV co-infection rate is reported to be 5.0% to 81.3% while 2.6% to 25.4 % have diabetes mellitus. Clinical symptoms of DR-epTB are consistent with morbidity in the affected body system. Among patients with DR-epTB, the proportion of MDR TB was 5% to 53% while that for pre-XDR TB and XDR TB was 3% to 40% and 4% to 33%, respectively. Treatment success is achieved in 26% to 83% of patients with DR-epTB while death, treatment loss-to-follow up, and treatment failure occur in 2% to 76%, 7% to 15%, and 0% to 4% respectively. Patients with DR-epTB were reported to have poorer outcomes than those with pulmonary DR-TB and extra-pulmonary drug-susceptible TB.</p></div><div><h3>Conclusion</h3><p>Clinical features of DR-epTB are similar to those observed among people with drug-susceptible EPTB but patients with DR-epTB post worse treatment outcomes.</p></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"33 ","pages":"Article 100390"},"PeriodicalIF":2.0,"publicationDate":"2023-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/88/c6/main.PMC10425399.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10020448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment of drug-resistant tuberculosis in children and young adolescents in Brazil","authors":"Fernanda Bruzadelli Paulino da Costa ,&nbsp;Thaís Zamboni Berra ,&nbsp;Jaqueline Garcia de Almeida Ballestero ,&nbsp;Patricia Bartholomay Oliveira ,&nbsp;Daniele Maria Pelissari ,&nbsp;Yan Mathias Alves ,&nbsp;Antônio Carlos Vieira Ramos ,&nbsp;Juliana Queiroz Rocha de Paiva ,&nbsp;Titilade Kehinde Ayandeyi Teibo ,&nbsp;Ricardo Alexandre Arcêncio","doi":"10.1016/j.jctube.2023.100388","DOIUrl":"10.1016/j.jctube.2023.100388","url":null,"abstract":"<div><h3>Introduction</h3><p>Drug-resistant tuberculosis (DR-TB) is a global threat and a challenge for public health authorities worldwide. In children, the diagnosis is even more challenging and DR-TB is poorly described in the literature, as are its treatment outcomes. In this study, we aimed to describe the treatment of drug-resistant TB in children and young adolescents in Brazil.</p></div><div><h3>Methods</h3><p>A descriptive epidemiological study of treatment for DR-TB in children under 15 years of age in Brazil between 2013 and 2020. The primary data source was the Information System for Special Tuberculosis Treatments (SITE-TB). Categorical variables were analyzed using relative frequencies (%) and continuous variables by measures of central tendency to characterize the profile of the cases, namely: sociodemographic, clinical characteristics, procedures, tests performed and treatment success. In order to verify the distribution of cases, a spatial analysis was carried out based on the municipality where the cases resided.</p></div><div><h3>Results</h3><p>Between 2013 and 2020, 19,757 tuberculosis (TB) cases occurred in children aged &lt;15 years in Brazil, and 46 cases of treatment for DR-TB were reported during the same period (annual average of 6 cases). Of these, 73.9% were aged 10–14, 65.2% were male, 4.3% were HIV+ and 43.3% were underweight (BMI&lt;18.5) at the start of treatment. 17.4% had previous contact with TB, 69.6% had primary resistance, 47.8% multidrug resistance. The median duration of treatment was 15 months. DOT and standardized treatment regimen were performed in 52.2% of cases. Bacilloscopy was performed for 97.8% (57.8% positive); culture for 89.1% (75.6% positive), rapid molecular test for 73.9% with proven resistance to rifampicin in 55.8%. Susceptibility testing revealed resistance mainly to isoniazid (87.8%) and rifampicin (60.6%). 73.9% of cases were successfully treated and one death was reported. Cases were treated in 26 Brazilian municipalities, with the majority in Rio de Janeiro (15) and São Paulo (4).</p></div><div><h3>Conclusion</h3><p>DR-TB treatment was recorded in &lt;1% of general TB cases in children and young adolescents, suggesting underreporting of drug-resistant cases in the country. Despite the low number of registered cases, the data reflect the situation of DR-TB in this population and describe important aspects of the problem, as the child needs comprehensive, individualized care, with support from different professionals. We recommend a strengthening of the country's referral services for the care of children with DR-TB so that surveillance and health care services can work together to identify and follow up cases.</p></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"33 ","pages":"Article 100388"},"PeriodicalIF":2.0,"publicationDate":"2023-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/14/b9/main.PMC10425933.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10076447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}