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Childhood tuberculosis and factors associated with mortality and loss to follow-up at a major paediatric treatment centre in Southern Ghana.
Afrane, Adwoa Kumiwa Asare; Alhassan, Yakubu; Ganu, Vincent; Adusi-Poku, Yaw; Goka, Bamenla Quarm; Kwara, Awewura.
  • Afrane AKA; Department of Child Health, Korle Bu Teaching Hospital, Accra, Ghana.
  • Alhassan Y; Department of Child Health, University of Ghana Medical School, Accra, Ghana.
  • Ganu V; Department of Biostatistics, School of Public Health, University of Ghana, Legon, Ghana.
  • Adusi-Poku Y; Infectious Disease Unit, Department of Medicine, Korle-Bu Teaching Hospital, Accra, Ghana.
  • Goka BQ; National Tuberculosis Control Programme, Ghana Health Service, Accra, Ghana.
  • Kwara A; Department of Child Health, Korle Bu Teaching Hospital, Accra, Ghana.
Pan Afr Med J ; 43: 90, 2022.
Article en En | MEDLINE | ID: mdl-36605983
ABSTRACT

Introduction:

tuberculosis (TB) is a major cause of morbidity and mortality in children in low- and middle-income countries. This study described the clinical presentation and identified factors contributing to poor outcome of childhood TB at Korle Bu Teaching Hospital (KBTH), Accra, Ghana.

Methods:

this was a retrospective cohort study of children aged ≤ 14 years with TB registered for treatment at KBTH from 2015 to 2019. Treatment outcomes were recorded as treatment success and unsuccessful outcomes (died and loss to follow-up). Multivariable logistics regression was conducted to assess factors associated with an unsuccessful outcome.

Results:

of 407 children with TB registered during the period, 269 (66.1%) patients had pulmonary tuberculosis (PTB). Of the 138 patients with extra-pulmonary TB (EPTB), 68 (49.3%) had TB lymphadenitis. The TB/HIV coinfection rate was 42.8%. The overall treatment success rate was 68.3%, whilst 71(17.4%) died, and 58 (14.3%) were lost to follow-up. Factors associated with death were age below 1 year (AOR 3.46, 95% CI 1.48-8.10, p=0.004) and having HIV coinfection (AOR 1.89, 95% CI 1.04-3.43, p=0.037). Factors associated with loss to follow-up were age below 1 year (AOR 2.91, 95% CI 1.12-8.59, p=0.029) and having EPTB (AOR 2.40, 95% CI 1.24-4.65, p=0.009).

Conclusion:

childhood TB treatment success in our population was below the national target of 85%, with high mortality and loss to follow-up rates, especially in younger children and those with HIV coinfection or EPTB. Tailored treatment strategies may be needed for children at risk of unsuccessful treatment outcome, especially among infants.
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Texto completo: 1 Banco de datos: MEDLINE Asunto principal: Tuberculosis Ganglionar / Infecciones por VIH / Coinfección Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Child / Humans / Infant País como asunto: Africa Idioma: En Año: 2022 Tipo del documento: Article

Texto completo: 1 Banco de datos: MEDLINE Asunto principal: Tuberculosis Ganglionar / Infecciones por VIH / Coinfección Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Child / Humans / Infant País como asunto: Africa Idioma: En Año: 2022 Tipo del documento: Article