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. 2022 Sep 18:5:79-85.
doi: 10.1016/j.ijregi.2022.09.005. eCollection 2022 Dec.

Temporal trend of drug-resistant tuberculosis among Thai children during 2006-2021

Watsamon Jantarabenjakul  1   2 , Praon Supradish Na Ayudhya  3 , Piyarat Suntarattiwong  3 , Nattawan Thepnarong  2 , Suwachreepon Rotcheewaphan  4 , Nibondh Udomsantisuk  4 , Juthamanee Moonwong  2 , Papada Kosulvit  3 , Monta Tawan  2 , Tavitiya Sudjaritruk  5   6 , Thanyawee Puthanakit  1   2
Affiliations

Temporal trend of drug-resistant tuberculosis among Thai children during 2006-2021

Watsamon Jantarabenjakul et al. IJID Reg. .

Abstract

Background: The prevalence of drug-resistant tuberculosis (DR-TB) in adults has stabilized in the past decade. Our study aimed to describe the prevalence of DR-TB in Thai children between 2006 and 2021.

Materials and methods: Children younger than 15 years old who had culture-confirmed Mycobacterium tuberculosis complex (MTB), positive PCR-MTB, or positive Xpert MTB/RIF were included in this cohort. Drug susceptibility testing (DST) was performed using phenotypic and/or genotypic methods. The prevalence of DR-TB was compared using the chi-square test.

Results: Among 163 confirmed TB cases (44% as pulmonary TB, 27% as extrapulmonary TB, and 29% with both), the median age (IQR) was 12.2 (7.3-14.2) years. DST was performed in 139 cases (85%), revealing prevalences of all DR-TB, isoniazid-resistant TB (Hr-TB), and rifampicin monoresistant/multidrug-resistant TB (Rr/MDR-TB) of 21.6% (95% CI 14.7-28.4), 10.8% (95% CI 5.6-16.0%), and 2.9% (95% CI 0.1-5.7%), respectively. The DR-TB rates did not differ significantly between 2006-2013, 2014-2018, and 2019-2021 (p > 0.05). Two pre-extensively DR-TB (pre-XDR) cases with fluoroquinolone resistance were detected after 2014.

Conclusion: The prevalence of DR-TB in Thai children was stable. However, one-tenth of DR-TB cases confirmed with DST were Hr-TB, which required adjustment of the treatment regimen. The pre-XDR cases should be closely monitored.

Keywords: DR-TB, Drug resistant tuberculosis; Hr-TB, Isoniazid-monoresistant tuberculosis; MDR-TB, Multidrug-resistant tuberculosis; Pre-XDR-TB, Pre-extensively drug-resistant tuberculosis; Rr-TB, Rifampicin-monoresistant tuberculosis; children; drug-resistant tuberculosis; fluoroquinolone; isoniazid-monoresistant tuberculosis (Hr-TB); multidrug-resistant tuberculosis (MDR-TB); pre-extensively drug-resistant tuberculosis (pre-XDR-TB); rifampicin-monoresistant tuberculosis (Rr-TB).

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Figure 1
Figure 1
The prevalence of DR-TB, Hr-TB, Rr-TB, MDR-TB, and pre-XDR-TB, 2006–2021
See this image and copyright information in PMC

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