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Article

Drug-Resistant Tuberculosis Treatment Outcomes among Children and Adolescents in Karachi, Pakistan

by
Amyn A. Malik
1,*,
Uzma Khan
1,
Palwasha Khan
1,2,
Aliya Anwar
3,
Naseem Salahuddin
3,
Saira Khowaja
1,
Aamir J. Khan
1,4,5,
Salman Khan
6,
Hamidah Hussain
1 and
Farhana Amanullah
3
1
Interactive Research and Development (IRD) Global, Singapore 049145, Singapore
2
London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK
3
The Indus Hospital and Health Network, Karachi 75190, Pakistan
4
Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA 02115, USA
5
Center for Global Health Delivery, Harvard Medical School, Boston, MA 02115, USA
6
Communicable Diseases Control, Department of Health, Government of Sindh, Hyderabad 65320, Pakistan
*
Author to whom correspondence should be addressed.
Trop. Med. Infect. Dis. 2022, 7(12), 418; https://doi.org/10.3390/tropicalmed7120418
Submission received: 25 October 2022 / Revised: 25 November 2022 / Accepted: 2 December 2022 / Published: 6 December 2022
(This article belongs to the Special Issue Holistic Approach to Tuberculosis Detection, Treatment and Prevention, Volume II)
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Abstract

Background: Significant data gaps exist for children and adolescents with drug-resistant (DR) TB, particularly from high TB incidence settings. This report provides a descriptive analysis of programmatic outcomes among children and adolescents treated for DR-TB in Pakistan. Methods: We extracted programmatic data from January 2014 to December 2019 from a tertiary care hospital with specialised child and adolescent DR-TB services. A physician assessed all children and adolescents (0–19 years) with presumptive DR-TB, including details of exposure to DR-TB, medical history, radiology, and laboratory results. All patients received treatment as per national DR-TB management guidelines based on WHO recommendations. Results: There were 262 treatment episodes for 247 patients enrolled during the study period. The median age of the cohort was 16 years (IQR: 13–18 years) with 16 (6.1%) children being under 5 years; 237 (90.5%) patients had pulmonary TB. The majority of the patients (194 or 74.1%) experienced a favourable treatment outcome and 26 (9.9%) died while on treatment. Female patients (78.5%) were more likely to experience favourable outcomes compared to males (64.7%; chi-sqr p-value = 0.02). Conclusions: We found high rates of favourable outcomes in children and adolescents treated for DR-TB. However, there were few young children in our cohort and there was a considerable gender gap that enhanced efforts to diagnose DR-TB in young children and to elucidate and mitigate the reasons for poor outcomes amongst males.
Keywords: drug-resistant TB; children; adolescents; treatment outcomes; Pakistan drug-resistant TB; children; adolescents; treatment outcomes; Pakistan

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MDPI and ACS Style

Malik, A.A.; Khan, U.; Khan, P.; Anwar, A.; Salahuddin, N.; Khowaja, S.; Khan, A.J.; Khan, S.; Hussain, H.; Amanullah, F. Drug-Resistant Tuberculosis Treatment Outcomes among Children and Adolescents in Karachi, Pakistan. Trop. Med. Infect. Dis. 2022, 7, 418. https://doi.org/10.3390/tropicalmed7120418

AMA Style

Malik AA, Khan U, Khan P, Anwar A, Salahuddin N, Khowaja S, Khan AJ, Khan S, Hussain H, Amanullah F. Drug-Resistant Tuberculosis Treatment Outcomes among Children and Adolescents in Karachi, Pakistan. Tropical Medicine and Infectious Disease. 2022; 7(12):418. https://doi.org/10.3390/tropicalmed7120418

Chicago/Turabian Style

Malik, Amyn A., Uzma Khan, Palwasha Khan, Aliya Anwar, Naseem Salahuddin, Saira Khowaja, Aamir J. Khan, Salman Khan, Hamidah Hussain, and Farhana Amanullah. 2022. "Drug-Resistant Tuberculosis Treatment Outcomes among Children and Adolescents in Karachi, Pakistan" Tropical Medicine and Infectious Disease 7, no. 12: 418. https://doi.org/10.3390/tropicalmed7120418

APA Style

Malik, A. A., Khan, U., Khan, P., Anwar, A., Salahuddin, N., Khowaja, S., Khan, A. J., Khan, S., Hussain, H., & Amanullah, F. (2022). Drug-Resistant Tuberculosis Treatment Outcomes among Children and Adolescents in Karachi, Pakistan. Tropical Medicine and Infectious Disease, 7(12), 418. https://doi.org/10.3390/tropicalmed7120418

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