Treatment Outcomes in Global Systematic Review and Patient Meta-Analysis of Children with Extensively Drug-Resistant Tuberculosis

• Published in: Emerging infectious diseases Vol. 25; no. 3; pp. 441 - 450
• Main Authors: Osman, Muhammad, Harausz, Elizabeth P., Garcia-Prats, Anthony J., Schaaf, H. Simon, Moore, Brittany K., Hicks, Robert M., Achar, Jay, Amanullah, Farhana, Barry, Pennan, Becerra, Mercedes, Chiotan, Domnica I., Drobac, Peter C., Flood, Jennifer, Furin, Jennifer, Gegia, Medea, Isaakidis, Petros, Mariandyshev, Andrei, Ozere, Iveta, Shah, N. Sarita, Skrahina, Alena, Yablokova, Elena, Seddon, James A., Hesseling, Anneke C.
• Format: Journal Article
• Language: English
• Published: United States U.S. National Center for Infectious Diseases 01.03.2019; Centers for Disease Control and Prevention
• Subjects: Adolescent; Age Factors; Analysis; antimicrobial resistance; Antitubercular agents; Antitubercular Agents - pharmacology; Antitubercular Agents - therapeutic use; Bedaquiline; Child; Child, Preschool; CME; Coinfection; Drug resistance; Drug therapy; Drugs; extensively drug-resistant tuberculosis; Extensively Drug-Resistant Tuberculosis - drug therapy; Extensively Drug-Resistant Tuberculosis - epidemiology; Female; Global Health; HIV; Humans; Infant; Infant, Newborn; Male; Microbial drug resistance; Microbial Sensitivity Tests; Mortality; Mycobacterium tuberculosis - drug effects; Patient outcomes; Population Surveillance; Treatment Failure; Treatment Outcome; Treatment Outcomes in Global Systematic Review and Patient Meta-Analysis of Children with Extensively Drug-Resistant Tuberculosis; tuberculosis; tuberculosis and other mycobacteria; XDR TB; South Africa; bacteria; XDR TB; tuberculosis; global systematic review; meta-analysis; multidrug-resistant TB; TB; respiratory infections; treatment outcomes; antimicrobial resistance; children; outcomes; extensively drug-resistant tuberculosis; mortality; tuberculosis and other mycobacteria; MDR TB
• ISSN: 1080-6040; 1080-6059; 1080-6059
• DOI: 10.3201/eid2503.180852

Extensively drug-resistant tuberculosis (XDR TB) has extremely poor treatment outcomes in adults. Limited data are available for children. We report on clinical manifestations, treatment, and outcomes for 37 children (<15 years of age) with bacteriologically confirmed XDR TB in 11 countries. These patients were managed during 1999-2013. For the 37 children, median age was 11 years, 32 (87%) had pulmonary TB, and 29 had a recorded HIV status; 7 (24%) were infected with HIV. Median treatment duration was 7.0 months for the intensive phase and 12.2 months for the continuation phase. Thirty (81%) children had favorable treatment outcomes. Four (11%) died, 1 (3%) failed treatment, and 2 (5%) did not complete treatment. We found a high proportion of favorable treatment outcomes among children, with mortality rates markedly lower than for adults. Regimens and duration of treatment varied considerably. Evaluation of new regimens in children is required.