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Weight-age score predicts effectiveness of childhood TB therapy
Weight change early in therapy predicted outcomes of childhood tuberculosis therapy, according to study results published in the Journal of the Pediatric Infectious Diseases Society.
Researchers in Lima, Peru, enrolled 100 children aged 17 years and younger who were being treated for drug-susceptible TB between 2012 and 2014 at health centers with high volumes of patients with TB (group 1) and children aged 15 years and younger who were treated for multidrug-resistant TB between 2005 and 2009 in the in the Lima metropolitan community (group 2).
They determined changes in patients’ weight-for-age score (WAZ) between baseline and the end of treatment at months 2 to 5 for group 1 and at months 2 to 8 for group 2. The researchers determined the accuracy of the change in WAZ to predict treatment failure or death by plotting receiver operating characteristic curves.
They reported that a lower change in WAZ in months 3 to 5 in group 1 and in month 7 for group 2 was associated with treatment failure or death. The researchers wrote that all children who experienced treatment failure or death had a lower change in WAZ than children who had received successful treatment, according to generalized estimating equation models.
The change in WAZ had a 60% to 90% sensitivity and a 60% to 86% specificity in months 2 to 5 for group 1 and months 7 to 8 in group 2, the researchers wrote.
They added that children who were successfully treated, except for children in group 2 with unknown biologic confirmation status, achieved weight gain.
“In the current study, we found that children whose treatment was ultimately successful had different weight trajectories than those whose treatment failed or who died,” the researchers wrote. “Furthermore, a change in WAZ early in therapy may serve as a moderately sensitive predictor of treatment failure or death for children receiving first-line TB regimens.”
They concluded, “if these findings are validated in other cohorts, the use of weight change to predict treatment outcome can lead to better outcomes for children with TB disease and more efficient clinical trial design in childhood TB therapy.” – by Bruce Thiel
Disclosures: The authors report no relevant financial disclosures.
