OUTCOMES OF PEDIATRIC DRUG-RESISTANT TB

Very few studies have reported on the outcomes of drug-resistant TB in children. One such study is from Peru, where 36 of 38 MDR TB cases were cured (Drobac et al., 2006). Another, conducted in South Africa in 2003, showed that of 39 confirmed MDR TB cases, the majority were clinically cured (Schaaf et al., 2003). More data on morbidity and longterm mortality in children, as well as on HIV-infected and HIV-uninfected children, are needed, said Schaaf.

Asked about the mortality figures for children with MDR and XDR TB, Schaaf replied that data since 2003 show 150 culture-confirmed cases of MDR TB, with a mortality rate of about 10 percent. There are currently 6 confirmed XDR TB cases, 3 with culture confirmation and 3 having had contact with adults with XDR TB. Schaaf said he has not had a child die from XDR TB.

Schaaf emphasized that if children are treated incorrectly when there is a known adult index case with MDR TB in the household, much lung damage can be done, leading to chronic lung disease. He suggested that mortality and morbidity should both be examined in looking at the outcomes of pediatric patients with MDR TB.



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