RT Journal Article
SR Electronic
T1 Multidrug-resistant tuberculosis in children: evidence from global surveillance
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP erj01758-2012
DO 10.1183/09031936.00175812
A1 Matteo Zignol
A1 Charalambos Sismanidis
A1 Dennis Falzon
A1 Philippe Glaziou
A1 Masoud Dara
A1 Katherine Floyd
YR 2012
UL http://erj.ersjournals.com/content/early/2012/12/06/09031936.00175812.abstract
AB Multidrug-resistant tuberculosis (MDR-TB) can affect persons of any age but it remains unknown whether children are more or less likely than adults to have MDR-TB.Representative drug resistance surveillance data reported to the World Health Organization between 1994 to 2011 were analysed to test the association between MDR-TB and age-group (children aged<15 vs adults aged≥15), using odds ratios (OR) derived by logistic regression with robust standard errors.Of 85 countries with data from nationwide surveys or surveillance systems, 35 reported at least one paediatric MDR-TB case. Aggregated data on age and drug susceptibility testing for 316,976 tuberculosis cases notified in these 35 countries were analysed. ORs for MDR-TB in children compared to adults varied widely between countries. In Germany, Namibia, South Africa, United Kingdom and United States, MDR-TB was positively associated with age<15 years. In the remaining countries no association was established.Despite the limitations intrinsic to the use of surveillance data and to the challenges of diagnosing childhood tuberculosis, our analysis suggests that proportions of MDR-TB in children and adults are similar in many settings. Of particular concern is the association found between age<15 years and MDR-TB in southern African countries with high HIV prevalence.