MDR TB now cur­able in chil­dren

78% of 975 young­sters had suc­cess­ful out­comes when treated with sec­ond-line drugs

Weekend Argus (Sunday Edition) - - HEALTH - LATOYA NEW­MAN

AU­THOR­I­TIES have wel­comed news that the dif­fi­cult-to-treat multi-drug re­sis­tant (MDR) tu­ber­cu­lo­sis can be suc­cess­fully treated in chil­dren – con­tend­ing that this will pave the way to­wards a shorter, less toxic and less painful treat­ment reg­i­men for the lit­tle ones.

The cur­rent treat­ment process for chil­dren af­fected by MDR is up to 18 months, in­clud­ing in­jectable an­tibi­otics with se­vere side ef­fects such as loss of hear­ing.

This week Cochrane SA – an in­tra­mu­ral re­search unit of the SA Med­i­cal Re­search Coun­cil (MRC) – and Stel­len­bosch Univer­sity an­nounced re­search re­sults from a large, in­ter­na­tional sys­tem­atic re­view – which demon­strated favourable treat­ment of MDR in chil­dren.

The study, which in­volved a col­lab­o­ra­tive group of in­ter­na­tional re­searchers, in­cluded a sys­tem­atic re­view and pa­tient data meta-anal­y­sis on the clin­i­cal char­ac­ter­is­tics and treat­ment out­comes of 975 chil­dren from 18 coun­tries.

The re­sults showed that 78% of these chil­dren’s treat­ment was suc­cess­ful when treated with sec­ond-line MDR TB drugs.

Ac­cord­ing to the World Health Or­gan­i­sa­tion, more than 250 000 chil­dren de­velop TB and 100 000 chil­dren will con­tinue to die each year from TB.

A child usu­ally gets TB from be­ing ex­posed to a spu­tum-pos­i­tive adult. Young chil­dren be­low 10 years are at high risk of de­vel­op­ing ac­tive TB as their im­mune sys­tem is not well de­vel­oped.

Up to now very lit­tle has been known about the op­ti­mal treat­ment for chil­dren due to dif­fer­ent chal­lenges in­clud­ing ad­her­ence to treat­ment due to the length of treat­ment, the tox­i­c­ity of drugs that are hard to tol­er­ate, and lack of child-friendly for­mu­la­tions.

Pro­fes­sor An­neke Hes­sel­ing, from the Des­mond Tutu TB Cen­tre at Stel­len­bosch Univer­sity, said the lat­est re­view “gives vi­tally im­por­tant in­for­ma­tion as to po­ten­tial out­comes and some good news for the TB field”.

She said this data showed that treat­ment out­comes of chil­dren when treated with sec­ond-line drugs was much bet­ter than those of adults.

The re­view in­volved rou­tine care where al­most 80% of chil­dren with ad­vanced MDR TB were cured.

“This shows that chil­dren can be cured of MDR TB and it pro­vides a huge ini­tia­tive for de­vel­op­ing treat­ments which are par­tic­u­larly suited to chil­dren’s needs to en­sure we don’t use a one-size-fit­sall, adult treat­ment of TB in chil­dren,” she said.

Hes­sel­ing said South Africa was on track in pi­o­neer­ing newer ther­a­pies for TB such as Bedaquilline – which has been hailed for its ef­fec­tive treat­ment of TB and short turn­around time.

Re­searchers at the

South African Na­tional Tu­ber­cu­lo­sis As­so­ci­a­tion (Santa) wel­comed the lat­est find­ings, say­ing its own re­search has in­di­cated some growth in TB in­fec­tions – par­tic­u­larly in ru­ral ar­eas.


The find­ings of a global re­view pave the way for less ex­ten­sive, less painful and less ‘toxic’ treat­ment of MDR TB in chil­dren – like the in­jec­tions.

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