Opportunities for preventive treatment of children with latent tuberculosis infection from focus with MDR-TB

According to WHO, the effectiveness of currently available preventive treatment schemes for people of the risk groups is from 60 to 90%. However, up to date, preventive treatment guidelines have not been developed for people who have been in contact with patients with MDR-TB. Objective of the research is to study the safety and efficacy of various regimens for the preventive treatment of children from MDR-TB contact. The study included children (average age 9.4 ± 4.2 years) with latent tuberculosis infection from contact with patients with MDR-TB. The patients were divided into three groups. Group 1 (30 people) received Z(pyrazinamide)+E (ethambutol), group 2 (30 patients) - Z+Pt (protionamide), group 3 (25 children) - Z+E+Pt. The treatment lasted for 3-4 months. The treatment regimen was prescribed taking into account the resistance of the causative agent of tuberculosis of the suspected index case. The preventive treatment was administered under the supervision of medical professionals. Tolerability of TB drugs (safety assessment): Under the Z+E regimen, no adverse events (AEs) were observed in any case. Under the Z+Pt regimen, AEs were observed in 28% of cases: in the form of nausea, eosinophilia, elevated liver enzymes. Under the Z+E+Pt regimen, AEs were observed in 13.3% of cases in the form of nausea, vomiting and abdominal pain. <b>Efficacy:</b> The observation period lasted for 1.5 years, no cases of tuberculosis were detected. <b>Conclusion:</b> The safest regimen was the one of 2 antituberculotics including ZE. Research on optimal preventive treatment regimens for children with MDR-TB contact should be continued.