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Drug-Resistant Tuberculosis Treatment Outcomes among Children and Adolescents in Karachi, Pakistan

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 pro...

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Autores principales: Malik, Amyn A., Khan, Uzma, Khan, Palwasha, Anwar, Aliya, Salahuddin, Naseem, Khowaja, Saira, Khan, Aamir J., Khan, Salman, Hussain, Hamidah, Amanullah, Farhana
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9788275/
https://www.ncbi.nlm.nih.gov/pubmed/36548673
http://dx.doi.org/10.3390/tropicalmed7120418
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author Malik, Amyn A.
Khan, Uzma
Khan, Palwasha
Anwar, Aliya
Salahuddin, Naseem
Khowaja, Saira
Khan, Aamir J.
Khan, Salman
Hussain, Hamidah
Amanullah, Farhana
author_facet Malik, Amyn A.
Khan, Uzma
Khan, Palwasha
Anwar, Aliya
Salahuddin, Naseem
Khowaja, Saira
Khan, Aamir J.
Khan, Salman
Hussain, Hamidah
Amanullah, Farhana
author_sort Malik, Amyn A.
collection PubMed
description 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.
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spelling pubmed-97882752022-12-24 Drug-Resistant Tuberculosis Treatment Outcomes among Children and Adolescents in Karachi, Pakistan Malik, Amyn A. Khan, Uzma Khan, Palwasha Anwar, Aliya Salahuddin, Naseem Khowaja, Saira Khan, Aamir J. Khan, Salman Hussain, Hamidah Amanullah, Farhana Trop Med Infect Dis Article 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. MDPI 2022-12-06 /pmc/articles/PMC9788275/ /pubmed/36548673 http://dx.doi.org/10.3390/tropicalmed7120418 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Malik, Amyn A.
Khan, Uzma
Khan, Palwasha
Anwar, Aliya
Salahuddin, Naseem
Khowaja, Saira
Khan, Aamir J.
Khan, Salman
Hussain, Hamidah
Amanullah, Farhana
Drug-Resistant Tuberculosis Treatment Outcomes among Children and Adolescents in Karachi, Pakistan
title Drug-Resistant Tuberculosis Treatment Outcomes among Children and Adolescents in Karachi, Pakistan
title_full Drug-Resistant Tuberculosis Treatment Outcomes among Children and Adolescents in Karachi, Pakistan
title_fullStr Drug-Resistant Tuberculosis Treatment Outcomes among Children and Adolescents in Karachi, Pakistan
title_full_unstemmed Drug-Resistant Tuberculosis Treatment Outcomes among Children and Adolescents in Karachi, Pakistan
title_short Drug-Resistant Tuberculosis Treatment Outcomes among Children and Adolescents in Karachi, Pakistan
title_sort drug-resistant tuberculosis treatment outcomes among children and adolescents in karachi, pakistan
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9788275/
https://www.ncbi.nlm.nih.gov/pubmed/36548673
http://dx.doi.org/10.3390/tropicalmed7120418
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