Extensively drug-resistant tuberculosis in children with human immunodeficiency virus in rural South Africa
| Autor: | Thomas, T. A., Sheela Shenoi, Heysell, S. K., Eksteen, F. J., Sunkari, V. B., Gandhi, N. R., Friedland, G., Shah, N. S. |
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| Jazyk: | angličtina |
| Rok vydání: | 2010 |
| Předmět: |
Male
Rural Population Anti-HIV Agents Extensively Drug-Resistant Tuberculosis Remission Induction Antitubercular Agents Sputum HIV Infections Mycobacterium tuberculosis Article South Africa Treatment Outcome Antiretroviral Therapy Highly Active Humans Female Radiography Thoracic Child Retrospective Studies |
| Zdroj: | Scopus-Elsevier |
| Popis: | Extensively drug-resistant tuberculosis (XDR-TB) has been documented worldwide, but reports of XDR-TB in children are extremely limited.To report the characteristics of pediatric XDR-TB patients in rural South Africa.We retrospectively reviewed children with sputum culture-confirmed XDR-TB from Tugela Ferry, South Africa, from January 2006 to December 2007. Demographic, clinical and microbiologic data were abstracted from medical records.Four children aged 6-8 years with XDR-TB were reviewed. Two had previous histories of TB. All were human immunodeficiency virus (HIV) infected orphans; three received highly active antiretroviral therapy (HAART) before XDR-TB diagnosis. All had clinical and radiographic improvement and sputum culture conversion while on standardized XDR-TB treatment and HAART. Two tolerated concomitant XDR-TB and HIV treatment well. Two experienced neuropsychiatric side effects related to cycloserine. All have survived24 months and all were cured. Prior to XDR-TB diagnosis, the children had resided in the hospital's pediatric ward for a median of 8 months (range 5-17), including a 3-month overlapping period.XDR-TB is a microbiologic diagnosis that, even with HIV co-infection, can be successfully identified. Concurrent XDR-TB and HIV therapy is feasible and effective in children, although more research is needed into potential overlapping toxicities. Nosocomial transmission is suggested, calling for infection control policies in pediatric wards. |
| Databáze: | OpenAIRE |
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