Children and multidrug-resistant tuberculosis : Original Text: CE Jones, B Kampmann
Mercedes Becerra and colleagues (Jan 8, p 147) report high rates of tuberculosis in household contacts of patients with multidrug-resistant or extensively drug-resistant (MDR/XDR) tuberculosis. We welcome their recommendation that a diagnosis of MDR or XDR tuberculosis should prompt systematic surveillance of household contacts and investigations. However, they seem to have overlooked young children present in these households.
Children contribute substantially to the global burden of tuberculosis and young children are at increased risk of disease progression and poor outcome, particularly within the first 12 months after exposure.The prompt assessment of children in a household affected by tuberculosis is therefore essential. Few data exist to guide management of children in close contact with adults with drug-resistant disease. Becerra and colleagues' study provided an excellent opportunity to gather such data, but results on children younger than 5 years seem to have been omitted, and data from older children are not reported separately from the adult cohort. No conclusions relating to the risk of disease in children can therefore be drawn from this study.
We acknowledge that the diagnosis of paediatric tuberculosis can be challenging, which might have been the reason why paediatric issues were not addressed in this paper. Despite these difficulties, however, epidemiological data are urgently required to inform preventive strategies for this vulnerable group.Failure to report paediatric data represents a missed opportunity to inform such strategies. Future household contact studies should include children of all ages and report paediatric data in addition to adults.
The Lancet, Volume 377, Issue 9775, Pages 1404 - 1405, 23 April 2011 http://image.thelancet.com/journals/lancet/article/PIIS0140-6736(11)60570-9/fulltext
Mercedes Becerra and colleagues (Jan 8, p 147) report high rates of tuberculosis in household contacts of patients with multidrug-resistant or extensively drug-resistant (MDR/XDR) tuberculosis. We welcome their recommendation that a diagnosis of MDR or XDR tuberculosis should prompt systematic surveillance of household contacts and investigations. However, they seem to have overlooked young children present in these households.
Children contribute substantially to the global burden of tuberculosis and young children are at increased risk of disease progression and poor outcome, particularly within the first 12 months after exposure.The prompt assessment of children in a household affected by tuberculosis is therefore essential. Few data exist to guide management of children in close contact with adults with drug-resistant disease. Becerra and colleagues' study provided an excellent opportunity to gather such data, but results on children younger than 5 years seem to have been omitted, and data from older children are not reported separately from the adult cohort. No conclusions relating to the risk of disease in children can therefore be drawn from this study.
We acknowledge that the diagnosis of paediatric tuberculosis can be challenging, which might have been the reason why paediatric issues were not addressed in this paper. Despite these difficulties, however, epidemiological data are urgently required to inform preventive strategies for this vulnerable group.Failure to report paediatric data represents a missed opportunity to inform such strategies. Future household contact studies should include children of all ages and report paediatric data in addition to adults.
The Lancet, Volume 377, Issue 9775, Pages 1404 - 1405, 23 April 2011 http://image.thelancet.com/journals/lancet/article/PIIS0140-6736(11)60570-9/fulltext
No comments:
Post a Comment