Skip to main content

The Emerging Threat of Drug-Resistant Tuberculosis in Southern Africa Global and Local Challenges and Solutions: Summary of a Joint Workshop by the Institute of Medicine and the Academy of Science of South Africa (2011) / Chapter Skim
Currently Skimming:

7 Drug-Resistant TB in Children
Pages 73-80

The Chapter Skim interface presents what we've algorithmically identified as the most significant single chunk of text within every page in the chapter.
Select key terms on the right to highlight them within pages of the chapter.


From page 73...
... EPIDEMIOLOGY OF PEDIATRIC DRUG-RESISTANT TB1 Drug susceptibility testing and DNA fingerprinting have demonstrated that MDR TB in children results mainly from transmitted drug resistance. 1 The remainder of this chapter is based on the presentation of Schaaf.
Read the entire page →
From page 74...
... The mother started treatment but defaulted and, not surprisingly, did not respond to the treatment. She was smear positive at 2 months, when her baby was born, and MDR TB was confirmed in December 2008.
Read the entire page →
From page 75...
... • Management of MDR TB in pregnancy needs to be studied and discussed further. • MDR TB and pre-XDR TB are curable diseases.
Read the entire page →
From page 76...
... . Pre-XDR TB is MDR TB that displays resistance to one of the fluoroquinolones or a second-line injectable drug.
Read the entire page →
From page 77...
... Drug-resistant TB should further be suspected if a child is adhering to treatment and fails therapy or if an adult source case with an unknown drug susceptibility test result is a treatment failure, is a retreatment case, or has died of TB during adherent treatment. DRUG TREATMENT REGIMENS FOR PEDIATRIC DRUG-RESISTANT TB According to the 2008 updated WHO guidelines on drug-resistant TB, the drugs used to treat MDR TB in children fall into five groups: • Group 1 -- Remaining first-line drugs: a combination of a high dose of isoniazid and ethionamide can create one effective drug.
Read the entire page →
From page 78...
... Primary, noncavitary MDR TB is often culture negative, and treatment for 12 to 15 months should suffice. Treatment in the intensive phase includes a second-line injectable drug, which is usually discontinued in the continuation phase.
Read the entire page →
From page 79...
... MANAGEMENT OF PEDIATRIC DRUG-RESISTANT TB The management of MDR TB in children should be carried out as follows, according to Schaaf: • Confirm MDR TB if at all possible. • If MDR TB is confirmed, also do drug susceptibility testing for second-line drugs.
Read the entire page →
From page 80...
... Schaaf said he has not had a child die from XDR TB. Schaaf emphasized that if children are treated incorrectly when there is a known adult index case with MDR TB in the household, much lung damage can be done, leading to chronic lung disease.
Read the entire page →

Key Terms

  • southern africa
  • injectable drug
  • drug treatment
  • drug resistance
  • western cape

  • adult source
  • susceptibility tests
  • pediatric mdr
  • prevent mdr
  • single drug

  • confirmed mdr
  • south africa
  • susceptibility test
  • susceptibility testing
  • isoniazid plus

  • adult index
  • prophylactic treatment
  • tuberculin skin
  • schaaf emphasized
  • phase includes

  • continuation phase
  • paucibacillary nature
  • line probe
  • monitor patients
  • line drug

  • confirmed xdr
  • renal function
  • microbiological diagnosis
  • children fall
  • plus ethambutol


    • This material may be derived from roughly machine-read images, and so is provided only to facilitate research.
    More information on Chapter Skim is available.