Drug-Resistant Tuberculosis Among Children: A Systematic Review and Meta-Analysis
Background: Drug-resistant tuberculosis (DR-TB), especially multidrug-resistant tuberculosis (MDR-TB) is a public health threat. Little is known about estimates of different profiles and rates of DR-TB among children globally.Methods: We did a systematic review and meta-analysis of observational stu...
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Frontiers Media S.A.
2021-08-01
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| Series: | Frontiers in Public Health |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fpubh.2021.721817/full |
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| author | Wan-mei Song Wan-mei Song Yi-fan Li Yun-xia Liu Yao Liu Chun-bao Yu Jin-yue Liu Huai-chen Li Huai-chen Li |
| author_facet | Wan-mei Song Wan-mei Song Yi-fan Li Yun-xia Liu Yao Liu Chun-bao Yu Jin-yue Liu Huai-chen Li Huai-chen Li |
| author_sort | Wan-mei Song |
| collection | DOAJ |
| description | Background: Drug-resistant tuberculosis (DR-TB), especially multidrug-resistant tuberculosis (MDR-TB) is a public health threat. Little is known about estimates of different profiles and rates of DR-TB among children globally.Methods: We did a systematic review and meta-analysis of observational studies reporting DR-TB among children by searching Embase, PubMed, and Scopus databases from January 1, 2000 to October 1, 2020. Publications reporting more than 60 children with bacteriological confirmed tuberculosis and phenotypical drug susceptibility testing (DST) results were included. Pooled proportions of MDR-TB and sub-analysis by age subgroups, regions, economical levels were performed.Results: We identified 4,063 studies, of which 37 were included. Of 23,652 pediatric TB patients, the proportions of DR-TB, MDR-TB, mono-resistant TB, polydrug resistant TB, extensively drug-resistant TB were 13.59% (1,964/14,453), 3.72% (881/23,652), 6.07% (529/8,719), 1.61% (119/7,361), 0.44% (30/6,763), respectively. The pooled proportion of MDR-TB among 23,652 children of 37 studies was 3.7% (95% CI, 3.5–4.0%). Rate of MDR-TB was much lower in high-income countries (1.8%) than that in lower-middle-income countries (6.3%) and upper-middle-income countries (7.3%). More specifically, the rates of MDR-TB were 1.7% in USA, 1.7% in UK, 2.9% in India, 6.0% in South Africa, 9.8% in China, respectively.Conclusions: The burden of DR-TB remains high in children, and there are potential associations between rates of pediatric MDR-TB and national economical levels. More interventions on child TB cases in low-income countries may be urgently needed in future. |
| first_indexed | 2024-12-14T16:19:21Z |
| format | Article |
| id | doaj.art-b08c067a602541ae84df5283d785e814 |
| institution | Directory Open Access Journal |
| issn | 2296-2565 |
| language | English |
| last_indexed | 2024-12-14T16:19:21Z |
| publishDate | 2021-08-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Public Health |
| spelling | doaj.art-b08c067a602541ae84df5283d785e8142022-12-21T22:54:51ZengFrontiers Media S.A.Frontiers in Public Health2296-25652021-08-01910.3389/fpubh.2021.721817721817Drug-Resistant Tuberculosis Among Children: A Systematic Review and Meta-AnalysisWan-mei Song0Wan-mei Song1Yi-fan Li2Yun-xia Liu3Yao Liu4Chun-bao Yu5Jin-yue Liu6Huai-chen Li7Huai-chen Li8Department of Respiratory and Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, ChinaCheeloo College of Medicine, Shandong University, Jinan, ChinaDepartment of Respiratory and Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, ChinaDepartment of Biostatistics, School of Public Health, Shandong University, Jinan, ChinaDepartment of Respiratory and Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, ChinaKatharine Hsu International Research Center of Human Infectious Diseases, Shandong Provincial Chest Hospital, Jinan, ChinaDepartment of Intensive Care Unit, Shandong Provincial Third Hospital, Jinan, ChinaDepartment of Respiratory and Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, ChinaCollege of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, ChinaBackground: Drug-resistant tuberculosis (DR-TB), especially multidrug-resistant tuberculosis (MDR-TB) is a public health threat. Little is known about estimates of different profiles and rates of DR-TB among children globally.Methods: We did a systematic review and meta-analysis of observational studies reporting DR-TB among children by searching Embase, PubMed, and Scopus databases from January 1, 2000 to October 1, 2020. Publications reporting more than 60 children with bacteriological confirmed tuberculosis and phenotypical drug susceptibility testing (DST) results were included. Pooled proportions of MDR-TB and sub-analysis by age subgroups, regions, economical levels were performed.Results: We identified 4,063 studies, of which 37 were included. Of 23,652 pediatric TB patients, the proportions of DR-TB, MDR-TB, mono-resistant TB, polydrug resistant TB, extensively drug-resistant TB were 13.59% (1,964/14,453), 3.72% (881/23,652), 6.07% (529/8,719), 1.61% (119/7,361), 0.44% (30/6,763), respectively. The pooled proportion of MDR-TB among 23,652 children of 37 studies was 3.7% (95% CI, 3.5–4.0%). Rate of MDR-TB was much lower in high-income countries (1.8%) than that in lower-middle-income countries (6.3%) and upper-middle-income countries (7.3%). More specifically, the rates of MDR-TB were 1.7% in USA, 1.7% in UK, 2.9% in India, 6.0% in South Africa, 9.8% in China, respectively.Conclusions: The burden of DR-TB remains high in children, and there are potential associations between rates of pediatric MDR-TB and national economical levels. More interventions on child TB cases in low-income countries may be urgently needed in future.https://www.frontiersin.org/articles/10.3389/fpubh.2021.721817/fulltuberculosischildrendrug resistancemeta-analysisnational economic levels |
| spellingShingle | Wan-mei Song Wan-mei Song Yi-fan Li Yun-xia Liu Yao Liu Chun-bao Yu Jin-yue Liu Huai-chen Li Huai-chen Li Drug-Resistant Tuberculosis Among Children: A Systematic Review and Meta-Analysis Frontiers in Public Health tuberculosis children drug resistance meta-analysis national economic levels |
| title | Drug-Resistant Tuberculosis Among Children: A Systematic Review and Meta-Analysis |
| title_full | Drug-Resistant Tuberculosis Among Children: A Systematic Review and Meta-Analysis |
| title_fullStr | Drug-Resistant Tuberculosis Among Children: A Systematic Review and Meta-Analysis |
| title_full_unstemmed | Drug-Resistant Tuberculosis Among Children: A Systematic Review and Meta-Analysis |
| title_short | Drug-Resistant Tuberculosis Among Children: A Systematic Review and Meta-Analysis |
| title_sort | drug resistant tuberculosis among children a systematic review and meta analysis |
| topic | tuberculosis children drug resistance meta-analysis national economic levels |
| url | https://www.frontiersin.org/articles/10.3389/fpubh.2021.721817/full |
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