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Pediatric Drug-Resistant Pulmonary Tuberculosis

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Diagnostic Imaging of Drug Resistant Pulmonary Tuberculosis


It was pointed out by WHO global tuberculosis report 2022 [1] that there were about 10.6 million newly diagnosed cases of tuberculosis worldwide in 2021, 1.2 million of which were children, accounting for 11%. 217,000 children died of tuberculosis in the same year, accounting for about 14% of the world’s deaths due to tuberculosis. The greater proportion of pediatric deaths than the estimated proportion suggests that children with tuberculosis have a lower chance to establish the diagnosis and acquire treatment. The report also pointed out that, the cumulative number of pediatric MDR/RR-TB patients registered for treatment between 2018 and 2021 was 17,700, only 15% of the global 5-year target of 115,000 from 2018 to 2022, which was set by the United Nations High level Conference. Some studies [2] have pointed out that there have been about 25,000–32,000 newly increased pediatric MDR-TB cases worldwide per year and the actual prevalence may be 12 times of the existing patients with confirmed diagnosis, through evaluating the incidence of pediatric MDR-TB by using MDR-TB risk model based on the integration of various global data. Pediatric drug-resistant tuberculosis tends to raise the rate of severe cases and mortality, especially in infants and young children (below 3 years old) prone to miliary tuberculosis and/or tuberculosis meningitis, and it would progress very easily from infection with tubercle bacillus because of their immaturely developed immune organs [3]. Characterized by high expenditure and multiple drugs required by the prolonged medication with adverse reaction commonly observed [4–6], pediatric drug-resistant tuberculosis can also become an important infectious source of drug-resistant tuberculosis [7]. Fortunately, the treatment success rate can reach to 78–90% [4, 8, 9], if the drug-resistant tuberculosis can be diagnosed in the early stage with treatment provided timely, owing to the low TB load in children. Diagnosis in early stage, therefore, seems to be the key link to cure pediatric drug-resistant tuberculosis. However, difficulties in acquiring etiological evidences for this disease predispose its diagnosis to a great challenge, making image examination become extremely important and likely the unique method, especially CT scans endowed with an overwhelming significance in clinical imaging diagnosis, differential diagnosis, and evaluation of responses and prognosis in pediatric population with this disease [10].

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Fang, Wj., Song, M., Han, Yy., Xu, Cj., Yi, Yx., Lu, Sh. (2023). Pediatric Drug-Resistant Pulmonary Tuberculosis. In: Lu, PX., Lu, Hz., Yi, Yx. (eds) Diagnostic Imaging of Drug Resistant Pulmonary Tuberculosis. Springer, Singapore.

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