What is it about?
This study is the largest analysis to date of children and adolescents (aged 0–19) treated for multidrug-resistant or rifampicin-resistant tuberculosis, based on a systematic review and individual participant data meta-analysis from 42 studies across multiple countries. It found that while treatment outcomes in this group were better than those typically seen in adults, they still fell short of global targets, with 72% treatment success. Use of two or more WHO group A drugs (such as bedaquiline and linezolid) significantly improved outcomes. The findings emphasize the need for broader access to these key drugs and greater efforts to diagnose and treat younger and clinically diagnosed patients who are currently underrepresented.
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Why is it important?
This study is important because it provides much-needed evidence on how to effectively treat children and adolescents with drug-resistant tuberculosis—a population that has historically been overlooked in research and clinical trials. By identifying which treatments lead to better outcomes, especially the use of WHO-recommended group A drugs, the study offers critical guidance for improving care and survival in this vulnerable group. It also highlights gaps in diagnosis and access to treatment for younger patients, pointing to the urgent need for targeted case-finding and faster, more equitable access to effective medications. This evidence can directly inform global and national TB policies to better protect children and adolescents from this deadly disease.
Perspectives
This study offers strong evidence to inform future treatment guidelines and policies for children and adolescents with MDR/RR-TB. It underscores the urgent need to prioritize younger patients in TB case detection and ensure they have access to effective, child-friendly formulations of WHO-recommended drugs. The clear association between treatment success and the use of group A drugs highlights the importance of integrating newer, more effective medications into pediatric TB programs. Going forward, more clinical trials and implementation research focused on children and adolescents are essential to optimize regimens, minimize side effects, and improve adherence. Strengthening health systems to support early diagnosis, comprehensive care, and treatment monitoring for this age group will be key to closing the gap between current outcomes and the global target of 90% treatment success.
Dr. Bakyt Bolotbekovich Myrzaliev
KNCV Tuberculosefonds
Read the Original
This page is a summary of: Characteristics of children and adolescents with multidrug-resistant and rifampicin-resistant tuberculosis and their association with treatment outcomes: a systematic review and individual participant data meta-analysis, The Lancet Child & Adolescent Health, February 2025, Elsevier,
DOI: 10.1016/s2352-4642(24)00330-4.
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