Overcoming challenges in the diagnosis, prevention, and treatment of pediatric drug-resistant tuberculosis.
Drug-resistant tuberculosis (DR-TB) is a growing global health threat and children are especially vulnerable to becoming infected and sick with DR-TB. There is a growing body of evidence on the optimal diagnosis, treatment and prevention of DR-TB in this vulnerable population. Areas covered: A comprehensive review of the literature on DR-TB in children was done using PubMed and Ovid databases up to 31 December 2016. Topic areas covered included diagnosis of DR-TB, treatment of DR-TB - including novel medications and regimens, prevention of DR-TB, community-based care, and stigma/discrimination. After presenting a case that highlights some of these challenges in each of these areas, for which we will propose mechanisms for overcoming them. Expert commentary: Overcoming the challenges facing children with DR-TB, requires a paradigm shift at multiple levels. The 'trickle down' approach to pediatric DR-TB has been woefully inadequate and it is essential that pediatric DR-TB - preventing it, diagnosing it, and treating it - be made a priority.
a Medicins Sans Frontiers , Southern African Medical Unit , Cape Town , South Africa.
Sylvie
S
Jonckheree
b Department of Global Health and Social Medicine , Harvard Medical School , Boston , MA , USA.
Jennifer
J
Furin
D000995:Antitubercular Agents / Q000627:therapeutic use*; D002648:Child; D006801:Humans; D018088:Tuberculosis, Multidrug-Resistant / Q000175:diagnosis* / Q000188:drug therapy* / Q000517:prevention & control
D000995:Antitubercular Agents
Drug-resistant tuberculosis; barriers; children; pediatrics