Multidrug-Resistant TB (MDR-TB) and Extensively Drug-Resistant TB (XDR-TB) Among Children: Where We Stand Now

Abstract

Drug-resistant tuberculosis (DR-TB) has continued to be a global health cataclysm. It is an arduous condition to tackle but is curable with the proper choice of drug and adherence to the drug therapy. WHO has introduced newer drugs with all-oral shorter regimens, but the COVID-19 pandemic has disrupted the achievements and raised the severity. The COVID-19 controlling mechanism is based on social distancing, using face masks, personal protective equipment, medical glove, head shoe cover, face shield, goggles, hand hygiene, and many more. Around the globe, national and international health authorities impose lockdown and movement control orders to ensure social distancing and prevent transmission of COVID-19 infection. Therefore, WHO proposed a TB control program impaired during a pandemic. Children, the most vulnerable group, suffer more from the drug-resistant form and act as the storehouse of future fatal cases. It has dire effects on physical health and hampers their mental health and academic career. Treatment of drug-resistant cases has more success stories in children than adults, but enrollment for treatment has been persistently low in this age group. Despite that, drug-resistant childhood tuberculosis has been neglected, and proper surveillance has not yet been achieved. Insufficient reporting, lack of appropriate screening tools for children, less accessibility to the treatment facility, inadequate awareness, and reduced funding for TB have worsened the situation. All these have resulted in jeopardizing our dream to terminate this deadly condition. So, it is high time to focus on this issue to achieve our Sustainable Development Goals (SDGs), the goal of ending TB by 2030, as planned by WHO. This review explores childhood TB's current position and areas to improve. This review utilized electronic-based data searched through PubMed, Google Scholar, Google Search Engine, Science Direct, and Embase.

Keywords: extensively drug-resistant tb (xdr tb); multidrug-resistant tb (mdr tb); mycobacterium tuberculosis; new financial investment.; pediatric population; sustainable development goals (sdgs); target regarding tb management; treatment success; tuberculosis; who- world health organization.

Figure 1. Highlighted events in TB history.

Note: This figure has been developed by utilizing the premium version of BioRender (https://biorender.com/) with License No.: CH24W5U6GS. A detail of the history of TB can obtain at the following link http://www.israelandyou.com/atlit-yam/ Image Credit: Susmita Sinha.

Figure 2. Schematic presentation of multidrug-resistant TB and extensively drug-resistant TB.

Note: This figure has been developed by utilizing the premium version of BioRender (https://biorender.com/) with License No.: YJ24X0TAQK. Image Credit: Susmita Sinha.

Figure 3. Depicting the various challenges for diagnosing and treating Drug-Resistant Tuberculosis among the pediatric population. Notes: DR-TB: Drug-Resistant Tuberculosis.

Note: This figure has been developed by utilizing the premium version of BioRender (https://biorender.com/) with License No.: BV24WGROUB. Image Credit: Rahnuma Ahmad

Figure 4. Illustrating the percentage of cases of Tuberculosis in Southeast Asia, Africa, and the Western Pacific region of the earth. Notes: TB: Tuberculosis.

Note: This figure has been developed by utilizing the premium version of BioRender (https://biorender.com/) with License No.: ZV24WK8LWK. Image Credit: Rahnuma Ahmad