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

• Main Authors: Muhammad Osman, Elizabeth P. Harausz, Anthony J. Garcia-Prats, H. Simon Schaaf, Brittany K. Moore, Robert M. Hicks, Jay Achar, Farhana Amanullah, Pennan Barry, Mercedes Becerra, Domnica I. Chiotan, Peter C. Drobac, Jennifer Flood, Jennifer Furin, Medea Gegia, Petros Isaakidis, Andrei Mariandyshev, Iveta Ozere, N. Sarita Shah, Alena Skrahina, Elena Yablokova, James A. Seddon, Anneke C. Hesseling
• Format: Article
• Language: English
• Published: Centers for Disease Control and Prevention 2019-03-01
• Series: Emerging Infectious Diseases
• Subjects: tuberculosis and other mycobacteria; tuberculosis; TB; extensively drug-resistant tuberculosis; XDR TB; antimicrobial resistance
• Online Access: https://wwwnc.cdc.gov/eid/article/25/3/18-0852_article
• ISSN: 1080-6040; 1080-6059

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.