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6 Drug-Resistant Tuberculosis in Pediatric Populations
6 Drug-Resistant Tuberculosis in Pediatric Populations
Pages 55-62
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From page 55... ...
But it reflects the broader spread of MDR TB and offers valuable lessons in how to prevent and treat the disease.
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From page 56... ...
Childhood TB cases, if reported, could help countries progress in diagnosis and treatment of all TB while also identifying gaps in treatment and knowledge. In the past 4 years, 4 reports of XDR TB in 1 or more children were published in Greece, Peru, South Africa, and the United States, respectively, and 1 each in Beijing and Mumbai, said Becerra, and more than 10 groups in the past 10 years have reported treating children for MDR TB.
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From page 57... ...
The resulting Sentinel roject on Pediatric Drug-Resistant Tuberculosis2 now includes more than P 250 individuals from more than 50 countries who are working to raise the visibility of this vulnerable population, share knowledge and best practices, and formulate a scientific agenda that gives priority to children. Since forming, one task force has gathered short stories detailing the experiences of almost 70 children with DR TB in more than 30 countries ("Being Brave: Stories of Children with Drug-Resistant Tuberculosis," 2012; "We Can Heal: Prevention, Diagnosis, Treatment, Care, and Support: Addressing Drug-Resistant Tuberculosis in Children," 2013)
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From page 58... ...
A framework that highlights basic treatment targets can be used as scaffolding for a scientific agenda that makes children a priority and can provide benchmarks for refining treatment and delivery strategies so as to increase the number of children treated. Pediatric Drug-Resistant TB in China3 Tao Li, Attending Physician, and Assistant Director, Department of Tuberculosis, Shanghai Public Health Clinical Center, Fudan University, began his presentation with the story of 4-year-old boy who has spent virtually his entire life in the hospital with DR TB.
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From page 59... ...
According to Huimin Li, MDR TB therapy should be considered if a patient has a history of TB, has an MDR TB contact, or has a poor clinical response to first-line TB therapy within 2 weeks despite adequate adherence to treatment. Treatment of drug-resistant TBM should be based on the results of DST, testing of the source case if possible, the prevailing patterns of drugresistant strains in the region, or the experience of practitioners.
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From page 60... ...
Huimin Li also presented the results of treating children with MDR TBM with linezolid, which has high in vitro antibacterial activity against TB. Research in adults has shown that linezolid is effective against MDR TB but also has a high incidence of serious adverse events, including neuropathies and bone marrow suppression.
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From page 61... ...
Analysis of the forms of drug resistance in pediatric TB showed generalized resistance to FLDs in 89 percent of children. Forty percent were resistant to kanamycin, and 38.5 percent had MDR TB.
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From page 62... ...
Russia has both a federal target program for preventing socially significant diseases and a subprogram for urgent measures to address TB. Aksenova concluded her presentation with a quote from Lucica Ditiu, executive secretary of the Stop TB Partnership: "Every day TB kills 200 children.
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