Tuberculosis in childhood

Shingadia, Delane

doi:10.1177/1753465812436662

Cited by 6 publications

(4 citation statements)

References 57 publications

(86 reference statements)

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“…However, although a naïve pooled data approach provides generally fairly accurate PK estimates [ 32 ], the observed variability emphasizes the need to evaluate these treatments on a population level and suggests that a nonlinear mixed-effects approach might provide a more mechanistic understanding of the variability and the influence of clinically important covariates. Pharmacokinetic parameter estimates in this study were generally in agreement with previous studies reporting pharmacokinetic properties of this first-line therapy in children with pulmonary TB [ 31 , 33 – 35 ] and TBM [ 4 , 36 , 37 ].…”

Section: Discussionsupporting

confidence: 91%

Naïve-pooled pharmacokinetic analysis of pyrazinamide, isoniazid and rifampicin in plasma and cerebrospinal fluid of Vietnamese children with tuberculous meningitis

et al. 2016

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Background: Among the various forms of TB, tuberculous meningitis (TBM) is the most severe, with about 30 % mortality and 50 % of survivors left with neurological sequelae. Children suffer more frequently from TBM than adults and outcomes are often poor due to difficulties in making the diagnosis and uncertainty regarding the best anti-tuberculosis drug regimen. The aim of this prospective study was to describe the pharmacokinetics of pyrazinamide, isoniazid and rifampicin in plasma and cerebrospinal fluid of children with tuberculous meningitis treated with the standard TBM regimen. Methods: We performed a prospective observational study of 100 consecutively treated children (≤15 years of age) with tuberculous meningitis in Ho Chi Minh City, Vietnam. Children were treated according to the 2006 WHO recommended pediatric treatment regimen consisting of isoniazid (5 mg/kg), rifampicin (10 mg/kg) and ethambutol (15 mg/kg) for 8 months, with the addition of pyrazinamide (25 mg/kg) for the first 3 months and streptomycin (15 mg/kg) for the first 2 months. Pyrazinamide, isoniazid and rifampicin concentrations were measured in plasma at day 14 and in cerebrospinal fluid (CSF) at 1 month by HPLC-UV. A naïve-pooled noncompartmental data analysis was used to describe the pharmacokinetic properties of drugs in the two-age groups of children ≤ 4 years or > 4 years of age. Results: Younger children, when compared to older children, presented a higher body weight-normalized clearance and volume of distribution, and lower median total plasma exposures for the three studied drugs with −14 %, −22 % and −16 % for Pyrazinamide, Isoniazid and Rifampicin, respectively. In CSF, individual concentrations of isoniazid and pyrazinamide were comparable to that in plasma in both age groups; but rifampicin concentrations were lower than the minimum inhibitory concentration of susceptible bacteria in all but two children. Conclusions: There is an age-dependent variation in the plasma and cerebrospinal fluid pharmacokinetics of rifampicin, isoniazid and pyrazinamide. The safety and efficacy of higher doses of rifampicin should be investigated for the treatment of childhood tuberculous meningitis.

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Section: Discussionsupporting

confidence: 91%

Naïve-pooled pharmacokinetic analysis of pyrazinamide, isoniazid and rifampicin in plasma and cerebrospinal fluid of Vietnamese children with tuberculous meningitis

et al. 2016

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“…Because they represent a public health risk and the source of MTB transmission, adult pulmonary TB cases with positive sputum smears are the focus of National TB Programs (NTPs) [6], [13][14][15]. Due to their infrequent development of lung cavities and the fact that the majority of them do not generate sputum, children are not typically considered to be a threat to the public's health [13], [21].…”

Section: Introductionmentioning

confidence: 99%

Prevalence of Tuberculosis in children using Gene Xpert on Gastric lavage samples

Chisompola,

Chanda,

Moono

et al. 2023

Preprint

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Background Tuberculosis (TB), caused by Mycobacterium tuberculosis (MTB), affects the lungs, kidneys, spine, and brain, has a significant global health challenge affecting 10–20% of children. Zambia is ranked in thirty countries with heavy burden. Early detection and intervention are crucial for managing the disease and preventing its progression to severe forms. Objective The aim of this study was to assess the prevalence of tuberculosis among children aged 0 to 10 years at the Arthur Davison Children's Hospital in Ndola, Zambia. The study specifically focused on children with coughs, and the preferred gastric lavage technique was used for sampling. Methodology: A cross-sectional study was conducted, we enrolled 138 children who were assessed using a structured questionnaire. To diagnosis TB, we employed x-rays and GeneXpert analysis of gastric lavage samples collected from January 2022 to February 2022. Results The results revealed that out of the 138 participants, 119 (86.2%) tested negative for mycobacterium tuberculosis, while 19 (13.8%) tested positive. GeneXpert detected 2 out of the 19 positives (1.4%), whereas chest x-ray identified all 19 positive cases (100%). Males showed a higher prevalence of MTB (52.6%) compared to females (47.4%), and the 0–4 age group had a higher MTB prevalence of 13 cases (68.4%) compared to 6 cases (31.6%) in the 5–10 age group. Conclusion In conclusion, the study showed a low prevalence of MTB (1.4%) in children under 10 years when using GeneXpert with gastric lavage samples. However, chest x-ray outperformed GeneXpert in detecting positive cases. The potential issues with the cumbersome process and the influence of gastric lavage sample acidity raise concerns about GeneXpert's effectiveness as the preferred choice for TB diagnosis in this population.

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“…These signs show that the patient has latent TB, while the absence of these signs signifies no TB infection. The patient's immune system reaction to Mycobacterium tuberculosis is measured during the Mantoux skin test (CDC, 2011;Shingadia, 2012). Though the Mantoux test is one of the most commonly used tests for TB screening, it tends to give contradictory results.…”

Section: Mantoux Tuberculin Skin Testmentioning

confidence: 99%

“…Though the Mantoux test is one of the most commonly used tests for TB screening, it tends to give contradictory results. Most times, false positive results are reported for individuals vaccinated with Bacille Calmette-Guérin (BCG) and patients with malnutrition and immunosuppression (Shingadia, 2012).…”

Section: Mantoux Tuberculin Skin Testmentioning

confidence: 99%

An ethnographic study of Knowledge, Attitudes and Health Seeking Behaviours of Patients, Healthcare Worker (HCWs) and Community Members towards Pulmonary Tuberculosis in Akure, Ondo State, Nigeria

Akinbileje¹

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This ethnographic study is an exploration of a research study conducted on Pulmonary Tuberculosis (PTB) infection that has claimed many lives. The incidence of TB in Nigeria in 2016 was estimated to be 219 cases per 100,000 population, which accounts for about 4% of the TB incidence globally. Nigeria holds the highest TB burden in West Africa with Nigeria among the 30 countries with the highest burden for pulmonary TB (PTB) and TB/HIV Multiple drug resistant-tuberculosis (MDR-TB) is prevalent in Africa. The management of PTB in Nigeria has been affected by the lack of funding, poor human resources, and weak health systems that are unable to support an efficient scale-up of TB services. Despite a high prevalence of MDR-TB in Nigeria, to date, there have been few or no qualitative studies which have sought to explore the knowledge, attitudes, and health-seeking behaviours that could influence the high prevalence of the disease. Aim: The aim of this study is to investigates the knowledge, attitudes, and health-seeking behaviours of patients, HCWs, and community members that comprises (Palace chiefs, religious leaders, traditional healers), in regard to PTB in Akure South, Ondo State, Nigeria. Methods: This ethnographic study adapted the health belief model and social ecological model as a theoretical framework. This ethnographic study used multiple methods of data collection methods, namely, semi structured interviews, focus groups, and participant observation in a PTB clinic and community DOTS site clinic. The purposive samples comprised of 2 community nominated leaders, 2 palace chiefs, 2 traditional healers, 2 religious’ leaders, 5 patients, 5 carers/relatives, and 12 healthcare workers. The focus groups who participated in the study comprised seven Muslim men, seven Muslim women, seven church groups and seven university students. The total sample size was 58 participants, and analysis of the data was performed using the NVivo programme. Findings: The study identified four themes:•Barriers to accessing healthcare services•Knowledge and perceptions of PTB•The socio-cultural context of PTB•Health promotion and preventionThe fear of PTB by society led to imposition of a social–physical distance of the community from PTB sufferers. Within the HCWs system, the fear of PTB affected the attitudes and behaviour of the HCWs towards the patients and the work with PTB. The doctors indicated that TB clinics were not adequately equipped to enable the provision of quality services. For accessing services, the fear of stigmatisation, traditional beliefs, and the implications of poverty resulted in people reporting to the hospital only after a prolonged period of self-medication. Many participants highlighted that religious and traditional beliefs resulted in a reluctance or refusal to accept PTB test results. The prevention and management of PTB in Nigeria is inadequate due to a lack of funding and human resources. Implications: The findings provide a baseline for the government to set up health promotion and disease prevention programmes in partnership with the community and non-governmental organisations (NGOs). Healthcare workers and NGOs can participate in promoting health education and prevention messages through mass media to the community to aid understanding of the disease. PTB services should be integrated into the curriculum to all schools, colleges, and universities, as well as religious programmes. The national tuberculosis and leprosy control programme (NTBLCP) is well placed to provide a monitoring and evaluation of progress.

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Tuberculosis in childhood

Cited by 6 publications

References 57 publications

Naïve-pooled pharmacokinetic analysis of pyrazinamide, isoniazid and rifampicin in plasma and cerebrospinal fluid of Vietnamese children with tuberculous meningitis

Naïve-pooled pharmacokinetic analysis of pyrazinamide, isoniazid and rifampicin in plasma and cerebrospinal fluid of Vietnamese children with tuberculous meningitis

Prevalence of Tuberculosis in children using Gene Xpert on Gastric lavage samples

An ethnographic study of Knowledge, Attitudes and Health Seeking Behaviours of Patients, Healthcare Worker (HCWs) and Community Members towards Pulmonary Tuberculosis in Akure, Ondo State, Nigeria

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