Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2012 Jan;16(1):76-81.
doi: 10.5588/ijtld.11.0360.

Rifampicin-monoresistant Mycobacterium tuberculosis disease among children in Cape Town, South Africa

A Dramowski  1 , M M Morsheimer, A M Jordaan, T C Victor, P R Donald, H S Schaaf
Affiliations

Rifampicin-monoresistant Mycobacterium tuberculosis disease among children in Cape Town, South Africa

A Dramowski et al. Int J Tuberc Lung Dis. 2012 Jan.

Abstract

Setting: Tygerberg Children's Hospital (TCH) and Brooklyn Chest Hospital (BCH), South Africa.

Objectives: To describe paediatric cases of rifampicin (RMP) monoresistant tuberculosis (RMR-TB) disease.

Design: Records of children with culture-confirmed RMR-TB between 1 March 2003 and 28 February 2009 were identified from a prospectively recorded database of drug-resistant TB at TCH and BCH. Mutation analysis was performed on available specimens.

Results: Eighteen children with a median age of 6.9 years (range 2 months-12.8 years) were identified. Nine (50%) were human immunodeficiency virus (HIV) infected and four (22%) were HIV-exposed but non-infected. Eleven (61%) had had previous TB treatment or prophylaxis. Nine children (50%) had cavitary disease and five children (22%) had extra-pulmonary disease. Twelve (67%) had adult TB source cases, including five (42%) adults with known RMR-TB. Primary transmission occurred among 11 children (61%) and acquisition of RMR-TB was possible in seven (39%) with prior RMP exposure. Median delay to specific RMR-TB treatment was 70 days (range 23-188). One child died from RMR-TB meningitis. Gene mutations consistent with RMR-TB were confirmed in five available samples.

Conclusion: RMR-TB disease is increasingly encountered, particularly among HIV-infected and HIV-exposed non-infected children. Delay in commencing appropriate treatment for RMR-TB and high rates of cavitary disease could be a source of RMR-TB transmission.

PubMed Disclaimer

Figures

Figure
Figure
Timeline of RMR-TB cases. RMR-TB = rifampicin-monoresistant TB.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Nelson LJ, Wells CD. Global epidemiology of childhood tuberculosis. Int J Tuberc Lung Dis. 2004;8:636–647. - PubMed
    1. Mahomed H, Kibel M, Hawkridge T, et al. The impact of a change in bacille Calmette-Guerin vaccine policy on tuberculosis incidence in children in Cape Town, South Africa. Pediatr Infect Dis J. 2006;25:1167–1172. - PubMed
    1. World Health Organization. Global report: UNAIDS report on the global AIDS epidemic UNAIDS/10.11E/JC1958E. Geneva, Switzerland: WHO; 2010. http://www.unaids.org/documents/20101123_GlobalReport_em.pdf Accessed October 2011.
    1. Shisana O, Rehle T, Simbayi LC, et al. the SABSSM III Implementation Team . Pretoria, South Africa: Human Sciences Research Council; 2009. South African National HIV Prevalence, Incidence, Behaviour and Communication Survey, 2008: a turning tide among teenagers? http://www.mrc.ac.za/pressreleases/2009/sanat.pdf Accessed October 2011.
    1. Hesseling AC, Cotton MF, Jennings T, et al. High incidence of tuberculosis among HIV-infected infants: evidence from a South African population-based study highlights the need for improved tuberculosis control strategies. Clin Infect Dis. 2009;48:108–114. - PubMed

Publication types

MeSH terms