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Treatment of drug-resistant tuberculosis in children and young adolescents in Brazil.
Bruzadelli Paulino da Costa, Fernanda; Zamboni Berra, Thaís; Garcia de Almeida Ballestero, Jaqueline; Bartholomay Oliveira, Patricia; Maria Pelissari, Daniele; Mathias Alves, Yan; Carlos Vieira Ramos, Antônio; Queiroz Rocha de Paiva, Juliana; Kehinde Ayandeyi Teibo, Titilade; Alexandre Arcêncio, Ricardo.
Afiliação
  • Bruzadelli Paulino da Costa F; Department of Maternal-Infant and Public Health Nursing, Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
  • Zamboni Berra T; Department of Maternal-Infant and Public Health Nursing, Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
  • Garcia de Almeida Ballestero J; Department of Maternal-Infant and Public Health Nursing, Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
  • Bartholomay Oliveira P; Health and Environment Surveillance Secretariat, Ministry of Health, Brazil.
  • Maria Pelissari D; Coordination of the Surveillance of Tuberculosis, Endemic Mycoses and Non-Tuberculous Mycobacteria, Ministry of Health, Brazil.
  • Mathias Alves Y; Department of Maternal-Infant and Public Health Nursing, Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
  • Carlos Vieira Ramos A; Department of Maternal-Infant and Public Health Nursing, Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
  • Queiroz Rocha de Paiva J; Municipal Tuberculosis Program of Ribeirão Preto, São Paulo, Brazil.
  • Kehinde Ayandeyi Teibo T; Department of Maternal-Infant and Public Health Nursing, Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
  • Alexandre Arcêncio R; Department of Maternal-Infant and Public Health Nursing, Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
J Clin Tuberc Other Mycobact Dis ; 33: 100388, 2023 Dec.
Article em En | MEDLINE | ID: mdl-37588725
Introduction: Drug-resistant tuberculosis (DR-TB) is a global threat and a challenge for public health authorities worldwide. In children, the diagnosis is even more challenging and DR-TB is poorly described in the literature, as are its treatment outcomes. In this study, we aimed to describe the treatment of drug-resistant TB in children and young adolescents in Brazil. Methods: A descriptive epidemiological study of treatment for DR-TB in children under 15 years of age in Brazil between 2013 and 2020. The primary data source was the Information System for Special Tuberculosis Treatments (SITE-TB). Categorical variables were analyzed using relative frequencies (%) and continuous variables by measures of central tendency to characterize the profile of the cases, namely: sociodemographic, clinical characteristics, procedures, tests performed and treatment success. In order to verify the distribution of cases, a spatial analysis was carried out based on the municipality where the cases resided. Results: Between 2013 and 2020, 19,757 tuberculosis (TB) cases occurred in children aged <15 years in Brazil, and 46 cases of treatment for DR-TB were reported during the same period (annual average of 6 cases). Of these, 73.9% were aged 10-14, 65.2% were male, 4.3% were HIV+ and 43.3% were underweight (BMI<18.5) at the start of treatment. 17.4% had previous contact with TB, 69.6% had primary resistance, 47.8% multidrug resistance. The median duration of treatment was 15 months. DOT and standardized treatment regimen were performed in 52.2% of cases. Bacilloscopy was performed for 97.8% (57.8% positive); culture for 89.1% (75.6% positive), rapid molecular test for 73.9% with proven resistance to rifampicin in 55.8%. Susceptibility testing revealed resistance mainly to isoniazid (87.8%) and rifampicin (60.6%). 73.9% of cases were successfully treated and one death was reported. Cases were treated in 26 Brazilian municipalities, with the majority in Rio de Janeiro (15) and São Paulo (4). Conclusion: DR-TB treatment was recorded in <1% of general TB cases in children and young adolescents, suggesting underreporting of drug-resistant cases in the country. Despite the low number of registered cases, the data reflect the situation of DR-TB in this population and describe important aspects of the problem, as the child needs comprehensive, individualized care, with support from different professionals. We recommend a strengthening of the country's referral services for the care of children with DR-TB so that surveillance and health care services can work together to identify and follow up cases.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Tipo de estudo: Prognostic_studies País/Região como assunto: America do sul / Brasil Idioma: En Revista: J Clin Tuberc Other Mycobact Dis Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Brasil País de publicação: Reino Unido

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Tipo de estudo: Prognostic_studies País/Região como assunto: America do sul / Brasil Idioma: En Revista: J Clin Tuberc Other Mycobact Dis Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Brasil País de publicação: Reino Unido