Surveillance of Antituberculosis Drug Resistance Among Children From the Western Cape Province of South Africa—An Upward Trend

Bibliographic Data

ID11034202
AuthorsH Simon Schaaf (0000-0001-5755-4133, The authors are with the Desmond Tutu Tuberculosis Centre, Department of Paediatrics and Child Health, Faculty of Health Sciences, Stellenbosch University, Cape Town, South Africa. H. Simon Schaaf, Ben J. Marais, and Peter R. Donald are also with Tygerberg Children's Hospital, Cape Town. Anneke C. Hesseling is also with the Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, England.), Benjamin Marais (0000-0003-3404-2690, Desmond Tutu HIV Foundation), Ben J Marais (The authors are with the Desmond Tutu Tuberculosis Centre, Department of Paediatrics and Child Health, Faculty of Health Sciences, Stellenbosch University, Cape Town, South Africa. H. Simon Schaaf, Ben J. Marais, and Peter R. Donald are also with Tygerberg Children's Hospital, Cape Town. Anneke C. Hesseling is also with the Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, England.), Anneke C Hesseling (0000-0001-9399-9834, The authors are with the Desmond Tutu Tuberculosis Centre, Department of Paediatrics and Child Health, Faculty of Health Sciences, Stellenbosch University, Cape Town, South Africa. H. Simon Schaaf, Ben J. Marais, and Peter R. Donald are also with Tygerberg Children's Hospital, Cape Town. Anneke C. Hesseling is also with the Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, England.), Wendy Brittle (The authors are with the Desmond Tutu Tuberculosis Centre, Department of Paediatrics and Child Health, Faculty of Health Sciences, Stellenbosch University, Cape Town, South Africa. H. Simon Schaaf, Ben J. Marais, and Peter R. Donald are also with Tygerberg Children's Hospital, Cape Town. Anneke C. Hesseling is also with the Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, England.), Peter R Donald (The authors are with the Desmond Tutu Tuberculosis Centre, Department of Paediatrics and Child Health, Faculty of Health Sciences, Stellenbosch University, Cape Town, South Africa. H. Simon Schaaf, Ben J. Marais, and Peter R. Donald are also with Tygerberg Children's Hospital, Cape Town. Anneke C. Hesseling is also with the Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, England.)
LanguageEN
References cited14

Objectives. We assessed the prevalence of antituberculosis drug resistance among children with tuberculosis (TB) in the Western Cape Province of South Africa. Methods. Drug susceptibility testing for isoniazid and rifampin was prospectively done on all children with culture-confirmed TB at Tygerberg Children's Hospital, Cape Town, from March 2005 through February 2007. Survey results were compared with results from 2 previous surveys. Results. We found 291 children had culture-confirmed TB. Resistance to isoniazid or rifampin increased from 21 of 306 (6.9%) to 41 of 319 (12.9%) and 43 of 285 (15.1%) in the first to third surveys (P = .005) and multidrug resistance from 7 of 306 (2.3%) to 18 of 319 (5.6%) and 19 of 285 (6.7%; P = .033). Although previously treated children had significantly more drug resistance than did new TB cases (19 of 66 [28.8%] vs 24 of 225 [10.7%]; odds ratio = 3.39; 95% confidence interval = 1.62, 7.05), evidence suggests transmission rather than acquisition of resistance. HIV infection was not significantly associated with drug resistance. Conclusions. Results indicate a high and rising prevalence of anti-TB drug resistance among children in the Western Cape, which suggests ongoing transmission of drug-resistant strains within the community. Improved control of TB in adults, including early identification and treatment of drug-resistant cases, is necessary to reduce transmission to children

Biology · Cape · Confidence interval · Drug · Drug resistance · Geography · Isoniazid · Odds ratio · Pathology · Transmission (telecommunications) · Tuberculosis · Infectious Diseases and Tuberculosis · Internal Medicine · Malaria Research and Control · Medicine · Microbiology · Pharmacology · Tuberculosis Research and Epidemiology · Pediatrics