Tuberculosis in children treated with second-line drugs under programmatic conditions in Lima, Peru.
Villarreal, J;
Alarcón, V;
Alarcón-Arrascue, E;
Moore, DAJ;
Heldal, E;
Mendoza-Ticona, A;
(2018)
Tuberculosis in children treated with second-line drugs under programmatic conditions in Lima, Peru.
The international journal of tuberculosis and lung disease, 22 (11).
pp. 1307-1313.
ISSN 1027-3719
DOI: https://doi.org/10.5588/ijtld.17.0911
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OBJECTIVE: To characterise childhood tuberculosis (TB) treated with second-line drugs (SLDs) in Lima, Peru. DESIGN: Results for the age groups <5 and 5-14 years were compared and treatment outcomes were assessed in cases reported between 2011 and 2015 from six districts of Lima. RESULTS: Of 96 reported cases, 82 were evaluated. Among these, 59% were boys; the median age was 8 years and 32% were aged <5 years. Contact with a TB case was reported in 82% of cases; 90% were treatment-naïve, 98% had pulmonary localisation and 50% underwent the tuberculin skin test (purified protein derivative), with induration 10 mm in 88%. A positive smear was found in 40%, all in the 5-14 years age group, and 46% were culture-positive. Only 26% had confirmed multidrug-resistant TB, 90% of whom were in the 5-14 years age group. SLDs for confirmed or probable drug-resistant TB (DR-TB) were administered to all cases, with a high proportion of success (over 83%), no failures or deaths and a high proportion of loss to follow-up. CONCLUSION: The main indication for SLDs in childhood TB was the empirical treatment of DR-TB due to contact with one or more identified DR-TB patients. Bacteriological confirmation was limited; however, treatment success was adequate.