Setting priorities for a research agenda to combat drug-resistant tuberculosis in children

Velayutham, Banurekha; Nair, Dina; Ramalingam, Suresh Babu; Pérez-Vélez, Carlos M.; Becerra, Mercedes C.; Swaminathan, Soumya

doi:10.5588/pha.15.0047

Cited by 8 publications

(3 citation statements)

References 22 publications

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“…In TB-prevalent countries, many challenges can delay the achievement of the "End TB" objectives. Among these challenges, research on MDR-TB in children is a priority 27 . There is a need to provide access to new MDR-TB drugs, especially for children 28 .…”

Section: Discussionmentioning

confidence: 99%

Multidrug Resistant Tuberculosis in Children in the Democratic Republic of Congo: First Experience With a Short Treatment Course in a University Hospital

Aketi

Joseph

Bakoko

et al. 2018

J. Drug Delivery Ther.

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Background: A short treatment course for multidrug-resistant tuberculosis (MR-TB) is not yet well codified in children in the Democratic Republic of Congo (DRC). The objective of this study was to evaluate a short MR-TB treatment course in children. Methods: A prospective study was performed from April 2015 (corresponding to the inclusion) through April 2017 (and the later initiation time point was April 2016) in the University Clinics of Kinshasa. Enrolled children were aged 0 to 15 years. The treatment duration was in general for 9 months, with 4 months of intensive phase treatment with Kanamycin, Levofloxacin, Isoniazid, Pyrazinamide, Prothionamide, Clofazimine and Ethambutol, and 5 months of continuous phase treatment with Levofloxacin, Pyrazinamide, Clofazimine and Ethambutol. Frequencies were reported for significant results. Results: A total of 21 children had MDR-TB (11 males and 10 females). Fifteen (71.43%) were bacteriological confirmed cases (by Xpert/MTB), and 6 (28.57%) were clinically diagnosed (MDR-TB contact with suggestive radiologic lesions); 2 patients were coinfected with HIV, 15 cases had pulmonary TB, and 6 had extrapulmonary TB. The main radiologic findings included TB cavity (3 cases), pleural effusion (5 cases), alveolar syndrome (8 cases), adenopathy (7 cases), and interstitial infiltration, fibrosis and miliary (2 cases each). The Ziehl control was negative before 4 months of treatment in the majority of the cases. Overall, 11 patients were cured, 7 completed the treatment, 2 died and 1 was lost to follow up. Conclusions: MDR-TB remains a challenge in children. A more comfortable, short treatment course is feasible in children in the DRC. It is necessary to verify this observation with a larger cohort of MDR-TB patients in pediatrics.

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Section: Discussionmentioning

confidence: 99%

Multidrug Resistant Tuberculosis in Children in the Democratic Republic of Congo: First Experience With a Short Treatment Course in a University Hospital

Aketi

Joseph

Bakoko

et al. 2018

J. Drug Delivery Ther.

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“…These examples are just three of many research questions with high potential to impact clinical care. 97 In conclusion, despite recent advances in the treatment of pediatric MDR-TB, there is significant room for improvement. Children and adolescents will continue to suffer disproportionately from this disease until clinicians, policy makers, and investigators prioritize pediatric MDR-TB, rather than treating it as an afterthought to adult-centered practice, policy, and research.…”

Section: Research Needsmentioning

confidence: 99%

Treatment of Multidrug-Resistant Tuberculosis in Children and Adolescents

Chiang

Furin

2017

J Pediatr Infect Dis

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Although tens of thousands of children and adolescents become sick with multidrug-resistant tuberculosis (MDR-TB) each year, fewer than 1,500 cases documenting treatment have been reported in the literature. Children treated for MDR-TB tend to have excellent clinical outcomes, but they suffer from the adverse events associated with current management strategies. This article will review the recommendations, evidence base, and future directions for MDR-TB therapy in children and adolescents.

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“…This current methodology was rigorous yet transparent while maintaining the anonymity of all respondents. Identifying research priorities from those working in the field with the necessary knowledge, experience, and expertise as to what research priorities for TB control programs should be of utmost importance [14][15][16].…”

Section: Plos Onementioning

confidence: 99%

The development of the national tuberculosis research priority in Indonesia: A comprehensive mixed-method approach

et al. 2023

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Ranked second in global tuberculosis (TB) incidence, Indonesia has developed a National Strategy for TB Prevention and Control 2020–2024 to accelerate the TB elimination program. Research and innovation are key pillars to support the program and need to be prioritised. This study aimed to develop updated national TB research priorities in Indonesia. This study was a mixed-methods study consisting of an open survey, a published literature survey, and Delphi survey. The open survey invited all related TB stakeholders to answer (a) the main barriers of the TB program and (b) the need for studies to support TB elimination. The published literature survey retrieved scientific articles published in national and international journals between 2015 and 2020 to identify gaps between published research and the current national strategy for TB control. The online survey and literature survey informed a panel of TB experts in a two-phase Delphi Survey to select the top 10 priority research topics. We identified 322 articles and analysed 1143 open survey responses. Through two-phases Delphi surveys, top ten research categories were listed: early TB detection; diagnosis and treatment of DR-TB; contact investigation; case detection and treatment of child TB; TB preventive therapy; government policy; laboratory for drug-sensitive- and drug-resistant-TB diagnosis; treatment adherence; diagnostic tool development; and community empowerment. This study also found the gap between stakeholders’ interests and the importance of translating research into policy and practice. TB research priorities have been identified through the involvement of various stakeholders. The combination of an online survey, a published literature survey, and a Delphi survey was a rigorous methodology and was fit to build a systematic consensus about the priority of TB research.

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Setting priorities for a research agenda to combat drug-resistant tuberculosis in children

Cited by 8 publications

References 22 publications

Multidrug Resistant Tuberculosis in Children in the Democratic Republic of Congo: First Experience With a Short Treatment Course in a University Hospital

Multidrug Resistant Tuberculosis in Children in the Democratic Republic of Congo: First Experience With a Short Treatment Course in a University Hospital

Treatment of Multidrug-Resistant Tuberculosis in Children and Adolescents

The development of the national tuberculosis research priority in Indonesia: A comprehensive mixed-method approach

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