Multidrug-resistant tuberculosis: prevalence

Multidrug-resistant tuberculosis (MDR-TB) and extensively-drug resistant Tuberculosis (XDR TB) has become the emerging diseases and health problems in the world. (Kritski et al., 1996, Becerra et al., 2011, Schaaf et al., 2003, Rahajoe et al., 2008). Children with tuberculosis contact investigation can only detect relatively active cases of TB (TB hospital) in small amounts in areas with low incidence, compared to areas with high incidence. (Bayona et al., 2003, Behr et al., 1998, Noertjojo et al., 2002, Topley et al., 1996, Kuaban et al., 1996, Marks et al., 2000). Children at high risk of contracting TB from household contacts (household) with MDR-TB so that both the identification of TB infection (latent TB) or TB hospital should be carried out systematically by taking into account various relevant factors. 

World Health Organization (WHO) estimates that one third of world population infected with M.tb, especially in Africa, Asia and Latin America child to the proportion of TB cases per year is 5-6%. Indonesia is currently ranked fifth of 22 countries with the highest number of TB sufferers in the world. According to WHO's Global Tuberculosis Control Report 2009, there were 528,063 new cases of TB incidence of 102 new smear positive cases per 100,000 population in 2007. Number of TB children aged <15 years in developing countries reached 15% while in developed countries 5-7% of all cases. An increasing number of TB cases in 1985-1992 occurred in the age of 25-44 years (54.5%), 0-4 years (36.1%) and 5-12 years (38.1%). TB cases in 2005 is estimated to rise 58% from 1990, 90% of them occur in developing countries. (Rahajoe et al., 2008). 

In children under five, sick of TB occurred in 8.5% of children and latent TB infection at 30.4%. (Morrison et al., 2008). In all age groups, 4.5% of household contacts suffering from TB and 51.4% had latent TB infection. Several studies in Africa reported a 14-45% household contacts of children suffering from latent TB infection and 23-34% of TB illness, with tracking done actively (Beyers et al., 1997). The proportion of latent TB infection were reported higher in Asia (30-70%), but the incidence of TB illness was lower (3-16.4%) than that reported in Africa. (Nguyen et al., 2009). 

Cases of MDR-TB is a major issue which, according to WHO, TB control if not true, the prevalence of MDR-TB was 5.5% whereas with the correct control of the implementation strategy of directly observed treatment short course (DOTS), the prevalence of MDR-TB only 1.6%. (Rahajoe et al., 2008). The data of MDR-TB official in Indonesia until saai not currently exist. (Rahajoe et al., 2008).

BAYONA, J., CHAVEZ-PACHAS, A. M., PALACIOS, E., LLARO, K., SAPAG, R. & BECERRA, M. C. 2003. Contact investigations as a means of detection and timely treatment of persons with infectious multidrug-resistant tuberculosis. Int J Tuberc Lung Dis, 7, S501-9.

BECERRA, M. C., APPLETON, S. C., FRANKE, M. F., CHALCO, K., ARTEAGA, F., BAYONA, J., MURRAY, M., ATWOOD, S. S. & MITNICK, C. D. 2011. Tuberculosis burden in households of patients with multidrug-resistant and extensively drug-resistant tuberculosis: a retrospective cohort study. Lancet, 377, 147-52.

BEHR, M. A., HOPEWELL, P. C., PAZ, E. A., KAWAMURA, L. M., SCHECTER, G. F. & SMALL, P. M. 1998. Predictive value of contact investigation for identifying recent transmission of Mycobacterium tuberculosis. Am J Respir Crit Care Med, 158, 465-9.

BEYERS, N., GIE, R. P., SCHAAF, H. S., VAN ZYL, S., TALENT, J. M., NEL, E. D. & DONALD, P. R. 1997. A prospective evaluation of children under the age of 5 years living in the same household as adults with recently diagnosed pulmonary tuberculosis. Int J Tuberc Lung Dis, 1, 38-43.

KRITSKI, A. L., MARQUES, M. J., RABAHI, M. F., VIEIRA, M. A., WERNECK-BARROSO, E., CARVALHO, C. E., ANDRADE GDE, N., BRAVO-DE-SOUZA, R., ANDRADE, L. M., GONTIJO, P. P. & RILEY, L. W. 1996. Transmission of tuberculosis to close contacts of patients with multidrug-resistant tuberculosis. Am J Respir Crit Care Med, 153, 331-5.

KUABAN, C., KOULLA-SHIRO, S., LEKAMA ASSIENE, T. & HAGBE, P. 1996. [Tuberculosis screening of patient contacts in 1993 and 1994 in Yaounde, Cameroon]. Med Trop (Mars), 56, 156-8.

MARKS, S. M., TAYLOR, Z., QUALLS, N. L., SHRESTHA-KUWAHARA, R. J., WILCE, M. A. & NGUYEN, C. H. 2000. Outcomes of contact investigations of infectious tuberculosis patients. Am J Respir Crit Care Med, 162, 2033-8.

MORRISON, J., PAI, M. & HOPEWELL, P. C. 2008. Tuberculosis and latent tuberculosis infection in close contacts of people with pulmonary tuberculosis in low-income and middle-income countries: a systematic review and meta-analysis. Lancet Infect Dis, 8, 359-68.

NGUYEN, T. H., ODERMATT, P., SLESAK, G. & BARENNES, H. 2009. Risk of latent tuberculosis infection in children living in households with tuberculosis patients: a cross sectional survey in remote northern Lao People's Democratic Republic. BMC Infect Dis, 9, 96.

NOERTJOJO, K., TAM, C. M., CHAN, S. L., TAN, J. & CHAN-YEUNG, M. 2002. Contact examination for tuberculosis in Hong Kong is useful. Int J Tuberc Lung Dis, 6, 19-24.

RAHAJOE, N. N., BASIR, D., MAKMURI & KARTASASMITA, C. B. 2008. Pedoman nasional tuberkulosis anak, Jakarta, UKK Respirologi PP IDAI.

SCHAAF, H. S., SHEAN, K. & DONALD, P. R. 2003. Culture confirmed multidrug resistant tuberculosis: diagnostic delay, clinical features, and outcome. Arch Dis Child, 88, 1106-11.

TOPLEY, J. M., MAHER, D. & MBEWE, L. N. 1996. Transmission of tuberculosis to contacts of sputum positive adults in Malawi. Arch Dis Child, 74, 140-3.