PLoS Medicine (Jul 2018)

Treatment and outcomes in children with multidrug-resistant tuberculosis: A systematic review and individual patient data meta-analysis.

  • Elizabeth P Harausz,
  • Anthony J Garcia-Prats,
  • Stephanie Law,
  • H Simon Schaaf,
  • Tamara Kredo,
  • James A Seddon,
  • Dick Menzies,
  • Anna Turkova,
  • Jay Achar,
  • Farhana Amanullah,
  • Pennan Barry,
  • Mercedes Becerra,
  • Edward D Chan,
  • Pei Chun Chan,
  • Domnica Ioana Chiotan,
  • Aldo Crossa,
  • Peter C Drobac,
  • Lee Fairlie,
  • Dennis Falzon,
  • Jennifer Flood,
  • Medea Gegia,
  • Robert M Hicks,
  • Petros Isaakidis,
  • S M Kadri,
  • Beate Kampmann,
  • Shabir A Madhi,
  • Else Marais,
  • Andrei Mariandyshev,
  • Ana Méndez-Echevarría,
  • Brittany Kathryn Moore,
  • Parpieva Nargiza,
  • Iveta Ozere,
  • Nesri Padayatchi,
  • Saleem- Ur-Rehman,
  • Natasha Rybak,
  • Begoña Santiago-Garcia,
  • N Sarita Shah,
  • Sangeeta Sharma,
  • Tae Sun Shim,
  • Alena Skrahina,
  • Antoni Soriano-Arandes,
  • Martin van den Boom,
  • Marieke J van der Werf,
  • Tjip S van der Werf,
  • Bhanu Williams,
  • Elena Yablokova,
  • Jae-Joon Yim,
  • Jennifer Furin,
  • Anneke C Hesseling,
  • Collaborative Group for Meta-Analysis of Paediatric Individual Patient Data in MDR-TB

DOI
https://doi.org/10.1371/journal.pmed.1002591
Journal volume & issue
Vol. 15, no. 7
p. e1002591

Abstract

Read online

BackgroundAn estimated 32,000 children develop multidrug-resistant tuberculosis (MDR-TB; Mycobacterium tuberculosis resistant to isoniazid and rifampin) each year. Little is known about the optimal treatment for these children.Methods and findingsTo inform the pediatric aspects of the revised World Health Organization (WHO) MDR-TB treatment guidelines, we performed a systematic review and individual patient data (IPD) meta-analysis, describing treatment outcomes in children treated for MDR-TB. To identify eligible reports we searched PubMed, LILACS, Embase, The Cochrane Library, PsychINFO, and BioMedCentral databases through 1 October 2014. To identify unpublished data, we reviewed conference abstracts, contacted experts in the field, and requested data through other routes, including at national and international conferences and through organizations working in pediatric MDR-TB. A cohort was eligible for inclusion if it included a minimum of three children (aged ConclusionsThis study suggests that children respond favorably to MDR-TB treatment. The low success rate in children infected with HIV who did not receive ART during their MDR-TB treatment highlights the need for ART in these children. Our findings of individual drug effects on treatment outcome should be further evaluated.