OBJECTIVES: We assessed the prevalence of antituberculosis drug resistance among children with tuberculosis (TB) in the Western Cape Province of South Africa. METHODS: Drug susceptibility testing for isoniazid and rifampin was prospectively done on all children with culture-confirmed TB at Tygerberg Children's Hospital, Cape Town, from March 2005 through February 2007. Survey results were compared with results from 2 previous surveys. RESULTS: We found 291 children had culture-confirmed TB. Resistance to isoniazid or rifampin increased from 21 of 306 (6.9%) to 41 of 319 (12.9%) and 43 of 285 (15.1%) in the first to third surveys (P = .005) and multidrug resistance from 7 of 306 (2.3%) to 18 of 319 (5.6%) and 19 of 285 (6.7%; P = .033). Although previously treated children had significantly more drug resistance than did new TB cases (19 of 66 [28.8%] vs 24 of 225 [10.7%]; odds ratio = 3.39; 95% confidence interval = 1.62, 7.05), evidence suggests transmission rather than acquisition of resistance. HIV infection was not significantly associated with drug resistance. CONCLUSIONS: Results indicate a high and rising prevalence of anti-TB drug resistance among children in the Western Cape, which suggests ongoing transmission of drug-resistant strains within the community. Improved control of TB in adults, including early identification and treatment of drug-resistant cases, is necessary to reduce transmission to children.
OBJECTIVES: We assessed the prevalence of antituberculosis drug resistance among children with tuberculosis (TB) in the Western Cape Province of South Africa. METHODS: Drug susceptibility testing for isoniazid and rifampin was prospectively done on all children with culture-confirmed TB at Tygerberg Children's Hospital, Cape Town, from March 2005 through February 2007. Survey results were compared with results from 2 previous surveys. RESULTS: We found 291 children had culture-confirmed TB. Resistance to isoniazid or rifampin increased from 21 of 306 (6.9%) to 41 of 319 (12.9%) and 43 of 285 (15.1%) in the first to third surveys (P = .005) and multidrug resistance from 7 of 306 (2.3%) to 18 of 319 (5.6%) and 19 of 285 (6.7%; P = .033). Although previously treated children had significantly more drug resistance than did new TB cases (19 of 66 [28.8%] vs 24 of 225 [10.7%]; odds ratio = 3.39; 95% confidence interval = 1.62, 7.05), evidence suggests transmission rather than acquisition of resistance. HIV infection was not significantly associated with drug resistance. CONCLUSIONS: Results indicate a high and rising prevalence of anti-TB drug resistance among children in the Western Cape, which suggests ongoing transmission of drug-resistant strains within the community. Improved control of TB in adults, including early identification and treatment of drug-resistant cases, is necessary to reduce transmission to children.
Authors: K F Laserson; L E Thorpe; V Leimane; K Weyer; C D Mitnick; V Riekstina; E Zarovska; M L Rich; H S F Fraser; E Alarcón; J P Cegielski; M Grzemska; R Gupta; M Espinal Journal: Int J Tuberc Lung Dis Date: 2005-06 Impact factor: 2.373
Authors: H Simon Schaaf; Ben J Marais; Anneke C Hesseling; Robert P Gie; Nulda Beyers; Peter R Donald Journal: Acta Paediatr Date: 2006-05 Impact factor: 2.299
Authors: H Simon Schaaf; Robert P Gie; Magdalene Kennedy; Nulda Beyers; Peter B Hesseling; Peter R Donald Journal: Pediatrics Date: 2002-05 Impact factor: 7.124
Authors: Ben J Marais; Tommie C Victor; Anneke C Hesseling; Madeleine Barnard; Annemie Jordaan; Wendy Brittle; Helmuth Reuter; Nulda Beyers; Paul D van Helden; Rob M Warren; H Simon Schaaf Journal: J Clin Microbiol Date: 2006-08-23 Impact factor: 5.948
Authors: S Swindells; A Gupta; S Kim; M D Hughes; J Sanchez; V Mave; R Dawson; N Kumarasamy; K Comins; B Smith; R Rustomjee; L Naini; N S Shah; A Hesseling; G Churchyard Journal: Int J Tuberc Lung Dis Date: 2018-09-01 Impact factor: 2.373
Authors: Helen E Jenkins; Arielle W Tolman; Courtney M Yuen; Jonathan B Parr; Salmaan Keshavjee; Carlos M Pérez-Vélez; Marcello Pagano; Mercedes C Becerra; Ted Cohen Journal: Lancet Date: 2014-03-24 Impact factor: 79.321
Authors: A Dramowski; M M Morsheimer; A M Jordaan; T C Victor; P R Donald; H S Schaaf Journal: Int J Tuberc Lung Dis Date: 2012-01 Impact factor: 2.373
Authors: A C Hesseling; S Kim; S Madhi; S Nachman; H S Schaaf; A Violari; T C Victor; G McSherry; C Mitchell; M F Cotton Journal: Int J Tuberc Lung Dis Date: 2012-02 Impact factor: 2.373
Authors: T A Thomas; S V Shenoi; S K Heysell; F J Eksteen; V B Sunkari; N R Gandhi; G Friedland; N S Shah Journal: Int J Tuberc Lung Dis Date: 2010-10 Impact factor: 2.373
Authors: Courtney M Yuen; Arielle W Tolman; Ted Cohen; Jonathan B Parr; Salmaan Keshavjee; Mercedes C Becerra Journal: Pediatr Infect Dis J Date: 2013-05 Impact factor: 2.129