Impact of Drug-Resistant Tuberculosis in Children: Clinical Features and Public Health Strategies

As drug-resistant tuberculosis (TB) develops in children, the disease becomes increasingly difficult to treat. This is because it is resistant to isoniazid and rifampicin, two of the best anti-TB drugs. The purpose of this study was to characterize the clinical profile of drug-resistant TB in children aged under 15 years. In patients with drug-resistant TB, drug susceptibility testing (DST) or contact with adults suffering from drug-resistant TB was used to identify patients. Patients were classified as monoresistant, polyresistant, MDR, or extensively drug-resistant (XDR) per WHO criteria, with further categorization into Partial XDR if resistance included a fluoroquinolone or aminoglycoside (excluding streptomycin). Key findings revealed a high prevalence of malnutrition, especially in younger children (<5 years), along with significant exposure to household TB contacts, primarily among those with MDR or Partial XDR. Pulmonary TB was the predominant form, though disseminated TB, abdominal TB, and TB lymphadenopathy were notable in the 5-10 year group. Children <5 years had greater vulnerability to severe forms, including TB meningitis (TBM). The study highlights the need for early detection, robust preventive strategies, and tailored treatment protocols, emphasizing MDR and Partial XDR in children with known drug-resistant contacts. Preventive measures such as comprehensive contact tracing, nutritional support, and adherence to treatment regimens are crucial. Public health efforts focused on reducing adult-to-child transmission and managing co-infections like HIV are essential in mitigating pediatric drug-resistant TB. Future studies should assess longitudinal treatment outcomes and investigate the molecular basis of resistance in children.