High Prevalence of Pediatric Multidrug-resistant tuberculosis (MDR-TB) in Sindh, Pakistan: A Cross Sectional Study

Yasmeen  Qureshi; Abdullah Dayo; Muhammad Ali Ghoto; Rafi Siddique; Jameela .; Geeta Kumari; Sania Begum; Razia Sultana; Jabbar Abbas; Tooba Khan

doi:10.56810/jpbm.003.02.0087

Authors

Yasmeen Qureshi Department of Pharmaceutics, Faculty of Pharmacy, University of Sindh, Jamshoro
Abdullah Dayo Department of Pharmaceutics, Faculty of Pharmacy, University of Sindh, Jamshoro
Muhammad Ali Ghoto Department of Pharmacy Practice, Faculty of Pharmacy, University of Sindh, Jamshoro
Rafi Siddique Institute of Chest Diseases, Kotri
Jameela . Department of Pharmaceutics, Faculty of Pharmacy, University of Sindh, Jamshoro
Geeta Kumari Department of Pharmacology, Faculty of Pharmacy, University of Sindh
Sania Begum Institute of Chest Diseases, Kotri
Razia Sultana Institute of Pharmaceutical Sciences, Peoples University of Medical and Health Sciences for Women, Nawabshah Shaheed Benazir Sindh
Jabbar Abbas Institute of Pharmaceutical Sciences, Peoples University of Medical and Health Sciences for Women, Nawabshah Shaheed Benazir Sindh
Tooba Khan Department of Pharmaceutics, Faculty of Pharmacy, University of Sindh, Jamshoro

DOI:

https://doi.org/10.56810/jpbm.003.02.0087

Keywords:

Tuberculosis, MDR-TB, pediatrics, Jamshoro

Abstract

Background: Tuberculosis (TB) is a contagious disease caused by mycobacterium tuberculosis bacteria, mostly affecting lungs. It is one of the main causes of death worldwide and nearly 100% of transmission, by which 230,000 children died and 1million suffering, according to recent data of World Health Organization (WHO). Multidrug resistant (MDR) TB became a threat to health security specially in developing countries. The antibiotics used in pediatrics need to have medical audit to ensure rational use because children are at three times higher risk level to have medication error and it is crucial for medical practioners and researchers to pay attention on growing rates of antibiotic resistance.Method: Purposive observational cross-sectional study. Date and place: 01-04-2016 to 29-04-2019, Hyderabad and Jamshoro. Children of ˂16 years of age were reviewed prospectively after their clinical examination (including growth valuation), routine blood tests, chest X-ray (CXR), and two sputum samples sent for Mycobacterial tuberculosis culture and drug-susceptibility testing (DST). Result: Of 649 patients, 183 patients were male (28%) and 466 were females (72%). Age group, most prone to TB was adolescent with 87% and least affected age was neonates and infants with 0%. Majority of patients belonged to rural areas with 67%. Most prescribed combination of antibiotic was pyrazinamide+ kanamycin+ levofloxacin+ ethionamide+ cycloserine + para-aminsalicylic acid with percentage of 41.6 but many antibiotics were changed during regimen. Line of therapy was followed in 639 patients (98.5%). Most common replacement therapy was pyrazinamide+ ethambutol+ amikacin+ levofloxacin+ ethionamide+ cycloserine with 25.4% out of total replacements with p-value ˂0.01. All prescribed antibiotics were with correct dose according to guidelines. Conclusion: Ratio of MDR-TB in pediatrics is very high and preventative medicines are extremely crucial but implementation of prophylactic measures for these cases is quite low.