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Published on: September 5, 2017
[Clinical characteristics and therapeutic effect of drug-resistant tuberculosis in children]
1Department of Pediatrics, West China Second Hospital, Sichuan University Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Sichuan University, Chengdu 610041, China.
Insights
This study found that second-line anti-tuberculosis (TB) therapy is effective for drug-resistant TB in children, with a low incidence of adverse drug reactions. The research analyzed clinical characteristics and treatment outcomes in pediatric patients.
Area of Science:
- Pediatric infectious diseases
- Clinical microbiology
- Public health
Background:
- Drug-resistant tuberculosis (TB) poses a significant challenge in pediatric populations.
- Understanding the clinical profile and treatment outcomes of drug-resistant TB in children is crucial for effective management.
- Second-line anti-TB therapies are essential for treating resistant strains but require careful evaluation for efficacy and safety in children.
Purpose of the Study:
- To investigate the clinical characteristics of drug-resistant TB in children.
- To evaluate the effectiveness of second-line anti-TB therapy in pediatric patients.
- To determine the incidence of adverse drug reactions associated with these treatments.
Main Methods:
- Retrospective analysis of clinical records of children diagnosed with drug-resistant TB.
- Data collected from West China Second Hospital between January 2010 and June 2014.
- Statistical analysis, including chi-squared test, to examine clinical characteristics, risk factors, treatment effectiveness, and adverse drug reactions.
Main Results:
- A drug resistance rate of 10.4% was observed in 46 pediatric TB patients.
- The majority of patients were in the >7 to 14 years age group (54.3%).
- An overall effective treatment rate of 87.0% was achieved, with an adverse drug reaction incidence of 10.9%.
Conclusions:
- Second-line anti-TB therapy demonstrates significant effectiveness in treating drug-resistant TB in children.
- The incidence of adverse drug reactions associated with these therapies in pediatric patients is relatively low.
- Clinical characteristics and risk factors, such as close contact with TB patients and prior irregular treatment, are important considerations.
Abstract:
Objective: To explore the clinical characteristics of drug-resistant tuberculosis (TB) in children and to study the effectiveness of second-line anti-TB therapy for children and to examine the incidence of adverse drug reactions. Method: Retrospective research was conducted. The clinical records of children in West China Second Hospital diagnosed as drug-resistant TB from January 2010 to June 2014 were investigated.The clinical characteristics and risk factors were analyzed retrospectively. Treatment effect at discharge was examined as a short-term outcome indicator to evaluate the effectiveness of second-line anti-TB therapy and the incidence of adverse drug reactions. χ(2) test was used. Result: Forty-six patients were diagnosed as drug-resistant TB in 443 children infected with TB, with a 10.4% resistance rate. The 46 children included 26 male and 20 female patients, aged from one month and 28 days to 17 years and 5 months, with the average age (8.4±4.5) years, >7 to 14 years old patients as the biggest part(25 patients, 54.3%). Among the 46 children, 20 patients(43.5%)had close contact with TB patients, of whom 12 patients (60.0%) contacted with family members (including parents, brothers and sisters and grandparents living together) and 8 patients(40.0%) contacted with patients from outside family (such as relatives or neighbors). Moreover, 11 cases (23.9%) were under initial treatment and 35 cases (76.1%) were retreated.From 2010 to 2014, the number of cases of initial and retreated patients had no significant difference(0 and 1, 1 and 13, 4 and 7, 4 and 11, 2 and 3 cases, χ(2)=3.255, P=0.196). Among retreated patients, 31.4% (11/35) had irregular treatment before.Until discharge, the effective rate was 87.0% (40/46), while the incidence rate of adverse drug reaction was 10.9%(5/46). Conclusion: The therapy for drug-resistant TB is effective and the incidence of adverse drug reaction is relatively low.
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