Drug-resistant tuberculosis treatment outcomes among children and adolescents in Karachi, Pakistan

• Published in: Tropical medicine and infectious disease Vol. 7; no. 12; pp. 1 - 9
• Main Authors: Malik, Amyn A., Khan, Uzma, Khan, Palwasha, Anwar, Aliya, Salahuddin, Naseem, Khowaja, Saira, Khan, Aamir J., Khan, Salman, Hussain, Hamidah, Amanullah, Farhana
• Format: Journal Article
• Language: English
• Published: Basel, Switzerland MDPI 06.12.2022; MDPI AG
• Subjects: adolescents; Age groups; children; Clinical outcomes; Demographics; Drug resistance; drug-resistant TB; Enrollments; Evaluation; Females; Males; Multidrug-resistant tuberculosis; Pakistan; Patients; Prevention; Success; Teenagers; Treatment; treatment outcomes; Tuberculosis; Tuberculosis in children; Karachi Pakistan; Pakistan; drug-resistant TB; Pakistan; treatment outcomes; adolescents; children
• ISSN: 2414-6366; 2414-6366
• DOI: 10.3390/tropicalmed7120418

Background: Significant data gaps exist for children and adolescents with drug-resistant (DR) TB, particularly from high TB incidence settings. This report provides a descriptive analysis of programmatic outcomes among children and adolescents treated for DR-TB in Pakistan. Methods: We extracted programmatic data from January 2014 to December 2019 from a tertiary care hospital with specialised child and adolescent DR-TB services. A physician assessed all children and adolescents (0-19 years) with presumptive DR-TB, including details of exposure to DR-TB, medical history, radiology, and laboratory results. All patients received treatment as per national DR-TB management guidelines based on WHO recommendations. Results: There were 262 treatment episodes for 247 patients enrolled during the study period. The median age of the cohort was 16 years (IQR: 13-18 years) with 16 (6.1%) children being under 5 years; 237 (90.5%) patients had pulmonary TB. The majority of the patients (194 or 74.1%) experienced a favourable treatment outcome and 26 (9.9%) died while on treatment. Female patients (78.5%) were more likely to experience favourable outcomes compared to males (64.7%; chi-sqr 'p'-value = 0.02). Conclusions: We found high rates of favourable outcomes in children and adolescents treated for DR-TB. However, there were few young children in our cohort and there was a considerable gender gap that enhanced efforts to diagnose DR-TB in young children and to elucidate and mitigate the reasons for poor outcomes amongst males.