A negative tuberculin skin test result should not delay treatment to tuberculosis treatment, particularly in those children who have other clinical markers of tuberculosis, according to data published online recently.
Peter C. Drobac, MD, of Partners in Health in Boston, and colleagues reported data on 2,392 children, up to age 14 years, who had been hospitalized in Peru for suspected TB. The retrospective cohort included 2,392 children during a 25-year period.
Drobac and colleagues reported that five children in their cohort had resistant TB. The World Health Organization estimates that 8.8 million people worldwide became infected with TB in 2010, with 1.4 million deaths as a result of the disease. Globally, children make up roughly 10% to 15% of those affected by multidrug-resistant-TB.
Two of the children in the study were HIV positive, and five children had documented multidrug-resistant TB and 266 of the children in the cohort died. Of these children, the researchers noted that reaction of less than 5 mm induration on TST predicted death. Other predictors of mortality included hemoptysis, peripheral edema and respiratory distress, and an altered mental status.
The researchers noted that rifampicin was linked with better treatment outcomes.
Partners in Health has provided care to more than 13,000 patients infected with MDR-TB in other international sites, including Peru, Haiti, Russia and Kazakhstan.
Disclosure: Dr. Drobac reports no relevant financial disclosures.