Rifampicin-monoresistant Mycobacterium Tuberculosis Disease Among Children in Cape Town, South Africa

Overview

Journal Int J Tuberc Lung Dis

Specialty Pulmonary Medicine

Date 2012 Jan 13

PMID 22236850

Citations 16

Authors

A Dramowski

M M Morsheimer

A M Jordaan

T C Victor

P R Donald

H S Schaaf

Affiliations

Soon will be listed here.

Abstract

Setting: Tygerberg Children's Hospital (TCH) and Brooklyn Chest Hospital (BCH), South Africa.

Objectives: To describe paediatric cases of rifampicin (RMP) monoresistant tuberculosis (RMR-TB) disease.

Design: Records of children with culture-confirmed RMR-TB between 1 March 2003 and 28 February 2009 were identified from a prospectively recorded database of drug-resistant TB at TCH and BCH. Mutation analysis was performed on available specimens.

Results: Eighteen children with a median age of 6.9 years (range 2 months-12.8 years) were identified. Nine (50%) were human immunodeficiency virus (HIV) infected and four (22%) were HIV-exposed but non-infected. Eleven (61%) had had previous TB treatment or prophylaxis. Nine children (50%) had cavitary disease and five children (22%) had extra-pulmonary disease. Twelve (67%) had adult TB source cases, including five (42%) adults with known RMR-TB. Primary transmission occurred among 11 children (61%) and acquisition of RMR-TB was possible in seven (39%) with prior RMP exposure. Median delay to specific RMR-TB treatment was 70 days (range 23-188). One child died from RMR-TB meningitis. Gene mutations consistent with RMR-TB were confirmed in five available samples.

Conclusion: RMR-TB disease is increasingly encountered, particularly among HIV-infected and HIV-exposed non-infected children. Delay in commencing appropriate treatment for RMR-TB and high rates of cavitary disease could be a source of RMR-TB transmission.

Citing Articles

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