The evolving epidemic of drug-resistant tuberculosis among children in Cape Town, South Africa

The International Journal of Tuberculosis and Lung Disease : the Official Journal of the International Union Against Tuberculosis and Lung Disease
J A SeddonH S Schaaf

Abstract

Tygerberg Children's Hospital, Cape Town, South Africa. To determine the prevalence and trend of drug resistance and human immunodeficiency virus (HIV) co-infection among children with culture-confirmed tuberculosis (TB). Prospective surveillance from March 2007 to February 2009, compared to three previous surveys (1994-1998, 2003-2005, 2005-2007). Drug susceptibility testing (DST) against isoniazid (INH) and rifampicin (RMP) was performed using genotypic and phenotypic testing. If multidrug-resistant TB (MDR-TB) was detected, further DST against ethambutol (EMB) and second-line drugs was performed. A total of 294 children with a median age of 26 months (range 3 days-13 years) were diagnosed with culture-confirmed TB. DST results were available for 292 (99.3%); 41 (14%) were INH-resistant, including 26 (8.9%) with MDR-TB. Four children (1.4%) had RMP monoresistance. EMB resistance was present in 12/24 (50%) MDR-TB cases tested. Two isolates were resistant to ofloxacin; none had extensively drug-resistant TB. Of those tested, 29% (63/217) were HIV-infected. Any resistance to RMP increased between 1994 and 2009 (P < 0.001), as did RMP monoresistance (P = 0.009) and MDR-TB (P < 0.001). Sensitivity was 87.5% and specificity 100% fo...Continue Reading

Citations

Sep 26, 2013·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·James A SeddonH Simon Schaaf
Apr 5, 2013·Journal of Clinical Microbiology·Ben J MaraisRobin M Warren
Apr 23, 2014·Current Opinion in Infectious Diseases·H Simon SchaafJames A Seddon
Sep 20, 2012·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·James A SeddonH Simon Schaaf
Dec 19, 2015·Indian Journal of Gastroenterology : Official Journal of the Indian Society of Gastroenterology·Rohan MalikRicha Lal
Sep 11, 2012·The Journal of Infection·James A SeddonH Simon Schaaf
Mar 24, 2015·Tuberculosis·S TheeH S Schaaf
Dec 19, 2009·Health Research Policy and Systems·Simon LewinSusan Munabi-Babigumira
Mar 27, 2015·International Journal of Infectious Diseases : IJID : Official Publication of the International Society for Infectious Diseases·Kauser JabeenRumina Hasan
Jul 23, 2014·Epidemiology and Infection·K SchopferB Richner
Jun 14, 2012·PloS One·Gesine Meyer-RathSydney Rosen
Oct 7, 2016·PloS One·Pascalina Chanda-KapataMartin P Grobusch
Jul 27, 2017·The Pediatric Infectious Disease Journal·Eric W HallSarah E Smith
Oct 18, 2018·Asian Spine Journal·Justin ArockiarajVenkatesh Krishnan
Sep 16, 2014·The Pediatric Infectious Disease Journal·Anthony J Garcia-PratsH Simon Schaaf
Jan 13, 2017·Philosophical Transactions of the Royal Society of London. Series B, Biological Sciences·David W Denning
Mar 3, 2020·Wellcome Open Research·James A SeddonUNKNOWN Tuberculous Meningitis International Research Consortium
Jun 11, 2020·The Pediatric Infectious Disease Journal·H Simon SchaafElisabetta Walters
Mar 3, 2020·Wellcome Open Research·James A SeddonUNKNOWN Tuberculous Meningitis International Research Consortium
Sep 8, 2021·Frontiers in Public Health·Wan-Mei SongHuai-Chen Li

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