The incidence of TB and MDR-TB in pediatrics and therapeutic options: a systematic review

Syst Rev. 2022 Aug 4;11(1):157. doi: 10.1186/s13643-022-02023-1.

Abstract

Background: Tuberculosis (TB) is considered one of the top 10 causes of death worldwide and the leading cause of death from a single infectious agent. Multidrug-resistant (MDR) TB can affect people of all age groups, including children (aged 0-15 years). However, very little is known about the extent of this problem in children. This systematic review aims to investigate the incidence of TB and drug-resistant (DR) TB among the pediatric population. It also reviews the therapeutic options available to treat the condition.

Methods: A comprehensive search for all relevant evidence was conducted. The following databases were searched: MEDLINE, CINAHL, and Web of Science. The searched time frame was limited from January 1990 to December 2020 with a focus on the incidence of TB and MDR-TB among pediatrics and the therapeutic options available.

Results: A total of 537 articles were obtained via the selected databases. After title and abstract screening, 418 articles were excluded leaving 119 articles. Full-text screening was conducted on 119 articles, excluding a further 110 articles. Thus, 9 articles were subject to quality assessment and included in this review. The 9 articles represented the age group of 0-15 years and included both males and females. All studies included were of retrospective study design.

Discussion: The included studies mentioned a moderate increase in TB cases among pediatrics exacerbated by malnutrition, lack of bacille Calmette-Guérin (BCG) vaccination, and human immunodeficiency virus (HIV) coinfection. MDR-TB prevalence was especially high in South Africa. Drug therapy for both TB and MDR-TB yielded favorable outcomes among pediatrics. However, one of the biggest challenges with drug therapy includes the dosage forms available.

Systematic review registration: DOI: 10.17605/OSF.IO/G34NF.

Keywords: Drug resistance; Incidence; Multidrug resistance; Outcome; Pediatrics; Treatment; Tuberculosis.

Publication types

  • Systematic Review

MeSH terms

  • Adolescent
  • Antitubercular Agents / therapeutic use
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Incidence
  • Infant
  • Infant, Newborn
  • Male
  • Retrospective Studies
  • Tuberculosis* / drug therapy
  • Tuberculosis* / epidemiology
  • Tuberculosis, Multidrug-Resistant* / drug therapy
  • Tuberculosis, Multidrug-Resistant* / epidemiology

Substances

  • Antitubercular Agents