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. 2023 Feb 17:10:2333794X231156048.
doi: 10.1177/2333794X231156048. eCollection 2023.

Trends in Rifampicin Resistance Among Children With Presumptive TB in the Pre-COVID and COVID-Era

Michael Abel Alao  1   2 , Babatunde Oluwatosin Ogunbosi  2 , Olayinka Rasheed Ibrahim  3
Affiliations

Trends in Rifampicin Resistance Among Children With Presumptive TB in the Pre-COVID and COVID-Era

Michael Abel Alao et al. Glob Pediatr Health. .

Abstract

Publications on COVID-19's impact on the global tuberculosis burden are from adult cohorts, pediatric data are lacking for inform decision. We compared the TB trends in southern Nigerian children in the pre-COVID-19 and COVID-19 era. This was a retrospective, cross-sectional study of early morning sputum/gastric washing or stool samples from children with presumptive TB evaluated using GeneXpert in a tertiary hospital from January 2016 to May 2022. Of the 20 589 persons screened for presumed TB in the pre-COVID-19 and the COVID-19 era, only 1104 (88.7%) of 1245 children had complete data for analysis. In the COVID era, a significantly higher number of children were presumed to have TB 755 (68.4%), P < .001. The overall incidence of MTB detected by Xpert MTB/RIF during the study period was 6.4% (71/1104). The incidence of MTB in the pre-COVID-19 era was 24/349 (6.9%), which was slightly higher than the COVID-19 era (47/755; 6.2%), P > .05). The annual trends of MTB detected peaked in 2019 [18/115; 15.7%] in the pre-COVID-19 era, then plummeted to 12/228 (5.3%) in 2020 in the COVID-19 era, and reached its all-time low of 6/160 (3.8%) in the first half of 2022, (P < .001). The overall incidence of Rifampicin-resistant TB (RR-TB) was 2.8% among the MTB detected cases and all occurred in the COVID-19 era. This study found a significant decline in MTB diagnosis and in the emergence of RR-TB in the COVID-19 era. This necessitates re-prioritizing worldwide efforts to manage childhood tuberculosis, including increased testing, if the aim of eliminating tuberculosis by 2035 is to be met.

Keywords: COVID-19; COVID-19 era; children; pre-COVID-19; rifampicin resistance; tuberculosis.

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Conflict of interest statement

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Prevalence of Mycobacterium tuberculosis detected by GeneXpert among the presumptive cases.
Figure 2.
Figure 2.
Trends of prevalence of MTB detected during pre-COVID-19 (2016-2019) and COVID-19 era (2020-2022).
Figure 3.
Figure 3.
Incidence of Rifampicin resistance (RR) among the patients with MTB detected.
Figure 4.
Figure 4.
Trends of Rifampicin resistance (RIF) during pre-COVID-19 (2016-2018) and COVID-19 era (2019-2022).
See this image and copyright information in PMC

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