Tuberculosis among children and adolescents in Rio de Janeiro, Brazil – Focus on extrapulmonary disease

Oliveira, Márcia Cortez Bellotti de; Sant’Anna, Clemax Couto; Raggio, R; Kritski, Afrânio Lineu

doi:10.1016/j.ijid.2021.02.023

Cited by 3 publications

(3 citation statements)

References 25 publications

(37 reference statements)

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“…Children and adolescents with HIV-TB co-infection experiencing EPTB face more than 3 times higher risk of mortality compared to children with co-existing PTB. This may be attributed to the more severe nature of EPTB, often surpassing PTB in severity [55]. It could also result from the simultaneous involvement of multiple organs [56], further increasing the risk of mortality in children already suffered from HIV.…”

Section: Discussionmentioning

confidence: 99%

Mortality of children and adolescents co-infected with tuberculosis and HIV: a systematic review and meta-analysis

Hu,

Tang,

et al. 2024

Aids

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Objective: Children and adolescents with HIV infection are well-known to face a heightened risk of tuberculosis. However, the exact mortality rates and temporal trends of those with HIV-TB co-infection remain unclear. We aimed to identify the overall mortality and temporal trends within this population. Methods: PubMed, Web of Science, and Embase were employed to search for publications reporting on the mortality rates of children and adolescents with HIV-TB co-infection from inception to March 2, 2024. The outcome is the mortality rate for children and adolescents with HIV-TB co-infection during the follow-up period. In addition, we evaluate the temporal trends of mortality. Results: During the follow-up period, the pooled mortality was 16% (95% CI 13–20). Single infection of either HIV or TB exhibit lower mortality rates (6% and 4%, respectively). We observed elevated mortality risks among individuals aged less than 12 months, those with EPTB, poor adherence to ART, and severe immunosuppression. In addition, we observed a decreasing trend in mortality before 2008 and an increasing trend after 2008, although the trends were not statistically significant (P = 0.08 and 0.2 respectively). Conclusions: Children and adolescents with HIV-TB co-infection bear a significant burden of mortality. Timely screening, effective treatment, and a comprehensive follow-up system contribute to reducing the mortality burden in this population.

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Section: Discussionmentioning

confidence: 99%

Mortality of children and adolescents co-infected with tuberculosis and HIV: a systematic review and meta-analysis

Hu,

Tang,

et al. 2024

Aids

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“…Наше дослідження виявило особливості клінічних форм ТБ, профіль медикаментозної стійкості МБТ і деякі чинники, які впливають на перебіг захворювання у дітей різних вікових груп. Частка ПТБ, за нашими даними, становила 9,8 %, що дещо менше, ніж за даними інших дослідників (14,2-17,7 %) [7,12]. Це свідчить про необхідність підвищення настороженості медичних працівників щодо ПТБ у дітей, застосування комплексного підходу до діагностики дитячого ТБ, широкого використання візуалізаційних та інших методів діагностики у клінічній практиці, вдосконалення стандартів надання медичної допомоги.…”

Section: результати та обговоренняunclassified

“…У нашому дослідженні виявлено, що із клінічних форм ПТБ у дітей раннього віку (до одного року життя) констатували лише дві -ТБ ПЛВ і ТБ мозкових оболонок та ЦНС, який незначно переважав. Останній асоційований з найвищим ризиком ускладнень і зростанням смертності [7,12]. C. Basanti та співавт.…”

Section: результати та обговоренняunclassified

Extrapulmonary tuberculosis among children: peculiarities of age’s groups and drug resistance of mycobacterium tuberculosis

Piskur¹,

Kostyk²,

Sakhelashvili³

et al. 2022

ТБ

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Objective — to analyze the peculiarities of detection and course of various clinical forms of extrapulmonary tuberculosis (EPTB), the profile of drug resistance of the Mycobacterium tuberculosis (MBT) among children of different ages. Materials and methods. We retrospectively analyzed the medical data of 47 children aged 0 to 14 with local forms of EPTB, hospitalized in the pediatric department of Lviv TB hospital from 2013 to 2020. Children were divided into groups: up to 1-year-olds (19 children; group I), 2—9 year-olds (19 children; group II) and 10—14-year-olds (9 children; group III). Results and discussion. It was found that children under 1 year of age were more likely to live in rural areas than in urban areas (78.9 vs. 21.1 %; p < 0.01). Resistant forms were diagnosed among 49.0 % of children. Among children of the first year of age this number reached 73.7 %, which is probably more often than among children aged 2—9 (26.3 %; p < 0.01). The numbers of multidrug-resistant TB (MDR-TB) and the risk of MDR-TB among children under one year of age were 35.7 and 28.6 %, respectively. The most common clinical form of EPTB was TB of peripheral lymph node (PLN) regardless of age (40.4 %). Only TB of PLN and TB of meningeal and CNS were found among children under 1 year of age. Among children aged 2—9, TB of PLN and TB of bone and joints were probably more common than all other localizations. TB of bones and joints among children aged 10—14 was more common than TB of eyes and skin. The proportion of TB of meninges and CNS in group I was probably higher compared to groups II and III (p1 < 0.01; p2 < 0.05). At the same time, TB of bones and joints among children of groups II and III was diagnosed significantly more often than in group I (p1 < 0.01; p2 < 0.05).In 89.4 % of cases EPTB was combined with pulmonary TB (PTB). Among children under one year of age, miliary PTB was diagnosed probably more often than other clinical forms (p < 0.05). Bilateral lesions were probably more common among children under one year of age than in children aged 10—14 (77.8 vs. 28.6 %; p < 0.05). Unilateral lesions were more common among children aged 10—14 than in children up to one year of age (22.2 vs. 71.4 %; p < 0.05). Children under 1 year of age and 2—9-year-olds were significantly more likely to be diagnosed with EPTB when seeking medical care than during examination of contact persons (63.2 vs. 26.3 %; 68.4 vs. 31.6 %; all p < 0.05) and during the preventive examination (10.5 % and 0; all p < 0.01). Also, EPTB was found more often among children aged 10—14 (66.7 vs. 0; p < 0.01). It was found that only 36.8 % of children of group I, 42.1 % of children of group II and 33.3 % of children of group III were sent to a specialized hospital after visiting the clinic.Patients under 1 year of age and 2—9-year-olds compared with children aged 10—14 were significantly more likely to have a combination of clinical manifestations of intoxication and bronchopulmonary syndromes (47.4 and 31.6 % vs. 0; p1 < 0.05; p2 < 0.01). At the same time, intoxication syndrome was significantly more common among children aged 10—14 than among children under one year of age (88.9 vs. 26.3 %; p < 0.01). Lack of vaccination was significantly more common among children under one year of age than in the following age groups (94.7 vs. 57.9 and 44.4 %; both p < 0.05), and the proportion of ineffective vaccinations was significantly higher among children aged 10—14 than in children under 1 year of age (55.6 vs. 5.3 %; p < 0.05). Conclusions. These data indicate the need to intensify preventive TB measures among children of different ages, as well as the need for enhanced control over vaccination, regular screening, monitoring of contacts among the adult population and their controlled treatment.

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Multidrug-Resistant TB (MDR-TB) and Extensively Drug-Resistant TB (XDR-TB) Among Children: Where We Stand Now

Chowdhury¹,

Ahmad²,

Sinha³

et al. 2023

Cureus

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Drug-resistant tuberculosis (DR-TB) has continued to be a global health cataclysm. It is an arduous condition to tackle but is curable with the proper choice of drug and adherence to the drug therapy. WHO has introduced newer drugs with all-oral shorter regimens, but the COVID-19 pandemic has disrupted the achievements and raised the severity. The COVID-19 controlling mechanism is based on social distancing, using face masks, personal protective equipment, medical glove, head shoe cover, face shield, goggles, hand hygiene, and many more. Around the globe, national and international health authorities impose lockdown and movement control orders to ensure social distancing and prevent transmission of COVID-19 infection. Therefore, WHO proposed a TB control program impaired during a pandemic. Children, the most vulnerable group, suffer more from the drug-resistant form and act as the storehouse of future fatal cases. It has dire effects on physical health and hampers their mental health and academic career. Treatment of drug-resistant cases has more success stories in children than adults, but enrollment for treatment has been persistently low in this age group. Despite that, drug-resistant childhood tuberculosis has been neglected, and proper surveillance has not yet been achieved. Insufficient reporting, lack of appropriate screening tools for children, less accessibility to the treatment facility, inadequate awareness, and reduced funding for TB have worsened the situation. All these have resulted in jeopardizing our dream to terminate this deadly condition. So, it is high time to focus on this issue to achieve our Sustainable Development Goals (SDGs), the goal of ending TB by 2030, as planned by WHO. This review explores childhood TB's current position and areas to improve. This review utilized electronic-based data searched through PubMed, Google Scholar, Google Search Engine, Science Direct, and Embase.

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Tuberculosis among children and adolescents in Rio de Janeiro, Brazil – Focus on extrapulmonary disease

Cited by 3 publications

References 25 publications

Mortality of children and adolescents co-infected with tuberculosis and HIV: a systematic review and meta-analysis

Mortality of children and adolescents co-infected with tuberculosis and HIV: a systematic review and meta-analysis

Extrapulmonary tuberculosis among children: peculiarities of age’s groups and drug resistance of mycobacterium tuberculosis

Multidrug-Resistant TB (MDR-TB) and Extensively Drug-Resistant TB (XDR-TB) Among Children: Where We Stand Now

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