Table 1

Characteristics of children treated for MDR-TB (n=149 unless otherwise stated)

CharacteristicVariableNumber (%) unless otherwise indicated
Median age in months (IQR)36 (18–66)
Male gender69 (46.3)
EthnicityXhosa90 (60.4)
Coloured59 (39.6)
Source caseNone identified20 (13.4)
MDR-TB111 (74.5)
Defaulter2 (1.3)
Died10 (6.7)
DS*6 (4.0)
Multiple source cases36 (24.2)
Median delay in days from start of MDR-TB episode to MDR-TB treatment (IQR)14 (0–53)
Positive TST (n=111)90 (81.1)
Previous TB13 (8.7)
Mean weight-for-age z score (SD; n=136)†−0.98 (1.54)
Mean height-for-age z score (SD; n=118)†−1.05 (1.79)
Mean weight-for-height z score (SD; n=64)†−0.29 (1.4)
Type of TBPulmonary alone120 (80.5)
Extrapulmonary alone12 (8.1)
Both17 (11.4)
Extrapulmonary involvement (more than one possible; n=29)Miliary TB4 (10.3)
TB meningitis7 (17.9)
Abdominal TB6 (15.4)
Peripheral lymph node TB6 (15.4)
Bone, joint or spinal TB8 (20.5)
Other1 (2.6)
Certainty of diagnosis of MDR-TBConfirmed59 (39.6)
Probable82 (55.0)
Possible‡8 (5.4)
Severity of diseaseNon-severe104 (69.8)
Severe45 (30.2)
Positive smear microscopy result for respiratory samples (n=46)23 (50.0)
HIV positive (n=146)32 (21.9)
WHO immunological stage (n=32)Not significant5 (15.6)
Mild3 (9.4)
Advanced11 (34.4)
Severe13 (40.6)
Timing of cART initiation (n=32)cART started prior to MDR-TB episode11 (34.4)
cART started after start of MDR-TB episode but before MDR-TB treatment10 (31.3)
cART started after MDR-TB treatment11 (34.4)
Median time to start cART after MDR-TB treatment in days (IQR; n=11)17 (12–35)
Drug resistance of isolate from child or from identified source case§Rifampicin (n=141)141 (100)
Isoniazid (n=141)125 (88.7)
Ethambutol (n=92)23 (25.0)
Ethionamide (n=102)5 (4.9)
Amikacin (n=104)¶16 (15.4)
Ofloxacin (n=103)¶14 (13.6)
Chest radiograph features at start of MDR-TB treatment (more than one possible; n=148)Normal16 (10.8)
Perihilar infiltrates32 (21.6)
Hilar lymphadenopathy or airways compression81 (54.7)
Lobar/segmental collapse or opacification69 (46.6)
Pleural effusion10 (6.8)
Cavities22 (14.9)
Miliary picture4 (2.7)
Widespread bronchopneumonic changes15 (10.1)
Chest radiograph severity (n=148)Non-severe72 (48.6)
Severe76 (51.4)
  • *Source case identified with no risk factors for MDR-TB.

  • †At start of MDR-TB treatment.

  • ‡All cases of possible MDR-TB diagnosed on basis of probable TB and failing first-line therapy.

  • §No DST to guide therapy in eight patients treated for failing first-line regimen with no identified source case.

  • ¶Six children were treated for XDR-TB due to samples from them or their source case demonstrating resistance to amikacin and ofloxacin.

  • cART, combination antiretroviral therapy; DS, drug susceptible; DST, drug susceptibility testing; MDR, multidrug resistant; TB, tuberculosis; TST, tuberculin skin test; XDR, extensively drug resistant.