%0 Journal Article
%T High prevalence of childhood multi-drug resistant tuberculosis in Johannesburg, South Africa: a cross sectional study
%A Lee Fairlie
%A Natalie C Beylis
%A Gary Reubenson
%A David P Moore
%A Shabir A Madhi
%J BMC Infectious Diseases
%D 2011
%I BioMed Central
%R 10.1186/1471-2334-11-28
%X Culture-confirmed cases of MTB in children under 14 years, attending two academic hospitals in Johannesburg, South Africa during 2008 were identified and hospital records of children diagnosed with drug-resistant TB were reviewed, including clinical and radiological outcomes at 6 and 12 months post-diagnosis. Culture of Mycobacterium tuberculosis complex (MTB) was performed using the automated liquid broth MGIT£¿ 960 method. Drug susceptibility testing (DST) was performed using the MGIT£¿ 960 method for both first and second-line anti-TB drugs.1317 children were treated for tuberculosis in 2008 between the two hospitals where the study was conducted. Drug susceptibility testing was undertaken in 148 (72.5%) of the 204 children who had culture-confirmed tuberculosis. The prevalence of isoniazid-resistance was 14.2% (n = 21) (95%CI, 9.0-20.9%) and the prevalence of MDR-TB 8.8% (n = 13) (95%CI, 4.8-14.6%). The prevalence of HIV co-infection was 52.1% in children with drug susceptible-TB and 53.9% in children with MDR-TB. Ten (76.9%) of the 13 children with MDR-TB received appropriate treatment and four (30.8%) died at a median of 2.8 months (range 0.1-4.0 months) after the date of tuberculosis investigation.There is a high prevalence of drug-resistant tuberculosis in children in Johannesburg in a setting with a high prevalence of HIV co-infection, although no association between HIV infection and MDR-TB was found in this study. Routine HIV and drug-susceptibility testing is warranted to optimize the management of childhood tuberculosis in settings such as ours.Sub-Saharan Africa has a high burden of human immunodeficiency virus (HIV) and Mycobacterium tuberculosis (MTB) infection. Most of the 2.1 million HIV-infected children live in sub-Saharan Africa including 10% in South Africa [1]. An estimated 10% of the 2.9 million new cases of tuberculosis in sub-Saharan Africa during 2007 occurred in children: 38% of all incident tuberculosis cases in sub-Saharan Africa (regardl
%U http://www.biomedcentral.com/1471-2334/11/28