Document Detail


Category based treatment of tuberculosis in children.
MedLine Citation:
PMID:  15475636     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Childhood tuberculosis is treated with multiple regimens for different clinical manifestations. World Health Organization has suggested a category-based treatment of tuberculosis that focuses on adult type of illness. To include children as DOTS beneficiaries, there is a need to assess the feasibility of classification and treatment of various types of childhood tuberculosis in different categories. METHODS: The study was conducted in the Pediatric Tuberculosis (TB) Clinic of a tertiary care hospital in North India. All children registered in the TB clinic were classified in four categories, similar to the categorization in World Health Organization's guidelines for treatment of tuberculosis in adults. All children with freshly diagnosed serious form of tuberculosis were included in category I. Category II included patients who had treatment failure, had interrupted treatment, relapse cases and those who were suspected to have drug resistant tuberculosis. Patients with primary pulmonary complex (PPC), single lymph node tuberculosis, minimal pleural effusion and isolated skin tuberculosis were included in category III. Category IV included patients who did not improve or deteriorated despite administration of 5 drugs (as per Category II) for at least 2 months. RESULTS: A total of 459 patients were started on antituberculosis drugs and were available for analysis. Pulmonary tuberculosis was the commonest followed by lymph node tuberculosis. Identification of AFB was possible only in 52 (11 percent) of the patients and was more commonly seen in lymph node tuberculosis. The mean age of the children was 93 months and sex distribution was almost equal. 323 patients were in category I, 12 in category II, 120 in category III and 4 in category IV. 365 (80 percent) children completed the treatment. Of these, 302 (82.7 percent) were cured with the primary regimen assigned to them in the beginning, 54 (14.8 percent) required extension of treatment for 3 months and 9 (2.5 percent) patients required change in the treatment regimen. Side effect in form of hepatotoxicity was observed in 12 (2.6 percent) patients and was significantly more in patients who were getting category IV treatment. CONCLUSION: It is feasible to classify and manage various types of tuberculosis in children in different categories similar to WHO guidelines for adult tuberculosis.
Authors:
S K Kabra; Rakesh Lodha; V Seth
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Indian pediatrics     Volume:  41     ISSN:  0019-6061     ISO Abbreviation:  Indian Pediatr     Publication Date:  2004 Sep 
Date Detail:
Created Date:  2004-10-11     Completed Date:  2004-11-02     Revised Date:  2010-03-24    
Medline Journal Info:
Nlm Unique ID:  2985062R     Medline TA:  Indian Pediatr     Country:  India    
Other Details:
Languages:  eng     Pagination:  927-37     Citation Subset:  IM    
Affiliation:
Department of Pediatrics, All India Institute of Medical Sciences, New Delhi 110029, India. skkabra@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Antitubercular Agents / administration & dosage*
Child
Child, Preschool
Directly Observed Therapy
Drug Administration Schedule
Drug Therapy, Combination
Feasibility Studies
Female
Humans
Infant
Male
Practice Guidelines as Topic
Treatment Outcome
Tuberculosis / classification*,  drug therapy*
Chemical
Reg. No./Substance:
0/Antitubercular Agents
Comments/Corrections
Comment In:
Indian Pediatr. 2005 Mar;42(3):299; author reply 299-300   [PMID:  15817992 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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