Subject(s)
Tuberculosis , Humans , Adolescent , Young Adult , Tuberculosis/prevention & control , ConsensusABSTRACT
The management of children with drug-resistant tuberculosis (DR-TB) is challenging, and it is likely that in many places, the roll-out of molecular diagnostic testing will lead to more children being diagnosed. There is a limited evidence base to guide optimal treatment and follow-up in the pediatric population; in existing DR-TB guidelines, the care of children is often relegated to small "special populations" sections. This article seeks to address this gap by providing clinicians with practical advice and guidance. This is achieved through review of the available literature on pediatric DR-TB, including research studies and international guidelines, combined with consensus opinion from a team of experts who have extensive experience in the care of children with DR-TB in a wide variety of contexts and with varying resources. The review covers treatment initiation, regimen design and treatment duration, management of comorbid conditions, treatment monitoring, adverse events, adherence promotion, and infection control, all within a multidisciplinary environment.
Subject(s)
Tuberculosis, Multidrug-Resistant/drug therapy , Antitubercular Agents/administration & dosage , Antitubercular Agents/adverse effects , Child , Directly Observed Therapy , Drug Monitoring , Humans , Tuberculosis, Multidrug-Resistant/complications , Tuberculosis, Multidrug-Resistant/diagnosis , Tuberculosis, Multidrug-Resistant/microbiologyABSTRACT
El objetivo del estudio fue determinar la asociación entre la inmunización con BCG y tuberculosis grave (TB). Se realizó un estudio retrospectivo, se incluyó fichas de pacientes atendidos en el servicio de neumología del Instituto Nacional de Salud del Niño de Perú, entre los años 1990-2000. Se revisaron un total de 2106 casos de TB entre los que había 259 casos graves (TB miliar o meningoencefalitis por TB). Del total, 497 casos no tenían antecedente de inmunización con BCG; 202 tenían TB grave y 295 TB no grave (OR igual a 0,05; IC 95 por ciento igual a 0,03-0,07). En conclusión, los niños con diagnóstico de TB y que han sido inmunizados con BCG, tienen 94 por ciento menos riesgo de desarrollar TB grave, en comparación a los niños con diagnóstico no inmunizados con BCG
