Treatment outcomes and tolerability of the revised WHO anti-tuberculosis drug dosages for children - PAR00017475 - Horizon

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Nansumba M., Kumbakumba E., Orikiriza P., Bastard M., Mwanga J. A., Boum Y., Beaudrap Pierre de, Bonnet Maryline. (2018). Treatment outcomes and tolerability of the revised WHO anti-tuberculosis drug dosages for children. International Journal of Tuberculosis and Lung Disease, 22 (2), 151-+. ISSN 1027-3719

Lien direct chez l'éditeur doi:10.5588/ijtld.17.0535

Titre
Treatment outcomes and tolerability of the revised WHO anti-tuberculosis drug dosages for children
Année de publication2018
Type de documentArticle référencé dans le Web of Science WOS:000429786700007
AuteursNansumba M., Kumbakumba E., Orikiriza P., Bastard M., Mwanga J. A., Boum Y., Beaudrap Pierre de, Bonnet Maryline.
SourceInternational Journal of Tuberculosis and Lung Disease, 2018, 22 (2), p. 151-+. ISSN 1027-3719
RésuméBACKGROUND: In 2010, the World Health Organization (WHO) revised the paediatric dosages of anti-tuberculosis drugs, increasing rifampicin to 15 mg/kg, isoniazid to 10 mg/kg and pyrazinamide to 35 mg/kg. We assessed treatment outcomes, safety and adherence among children treated with the new recommended dosages. METHODS : Prospective cohort of children started on anti-tuberculosis treatment in Uganda with 12 months of follow-up, including alanine aminotransferase (ALT) monitoring. Treatment intake was observed. RESULTS : Of 144 treated children, 81 were male (56.3%), 106 (73.6%) were aged,5 years, 30 (22%) had moderate to severe malnutrition and 48 (33.3%) had human immunodeficiency virus infection. Treatment outcomes were as follows: 117 (81.3%) successes, 3 (2.1%) failures, 4 (2.8%) lost to follow-up, 19 (13.2%) deaths and 1 (0.7%) transferred out. There was no relapse. Severe malnutrition (adjusted hazard ratio 8.76, 95% confidence interval [CI] 1.59-48.25) was the only predictor of death. Two serious adverse events were attributed to treatment: one case of increased ALT and one with peripheral neuropathy. Median ALT values at baseline and at weeks 2, 4 and 8 were respectively 24 (interquartile range [IQR] 16-39), 26 (IQR 18-38), 28 (IQR 21-40) and 27 (IQR 19-38) international units/l. Treatment adherence was above 85% on all visits. CONCLUSION: We confirm the good tolerability of and adherence to the new treatment recommendations. The increased risk of fatal outcome among severely malnourished children requires attention.
Plan de classementSanté : généralités [050]
Descr. géo.OUGANDA
LocalisationFonds IRD
Identifiant IRDPAR00017475
Lien permanenthttp://www.documentation.ird.fr/hor/PAR00017475

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