Background. In Cameroon, there are limited data on treatment outcomes of pediatric tuberculosis (TB). We sought to identify the factors associated with unsuccessful treatment outcomes and the risk factors for mortality among children receiving TB treatment in the Centre Region of Cameroon. Methods. This was a multicentre facility-based retrospective cohort study using routinely collected programmatic data. All children <15 years old treated for TB between 2018 and 2020 in 21 health facilities were included. We assessed risk factors for experiencing an unsuccessful treatment outcome and mortality through multivariable logistic regression analysis. Results. Of the 610 children with TB, 307 (50.3%) were females and the median age was 6 years (IQR = 2–12). One hundred and fifty-three (25.1%) of the children were TB/HIV co-infected patients. TB treatment success (cases categorized as cured and completed treatment) was observed in 488 (80.0%) of the patients. Unsuccessful treatment outcomes were experienced by 122 (20.0%) children. Of these, 73 (12.0%) died, 4 (0.6%) had treatment failure, 25 (4.1%) were lost to follow-up, and the outcomes of 20 (3.3%) children were not evaluated. In multivariable analysis, HIV-positive status (adjusted odds ratio [AOR] = 2.43; 95% CI, 1.55–3.80, p < 0.001 ) and clinical method of TB diagnosis (AOR = 2.46; 95% CI, 1.55–3.91, p < 0.001 ] were associated with unsuccessful treatment outcomes. HIV-positive status (AOR = 4.23; 95% CI, 2.44–7.33, p < 0.001 ) and clinical method of TB diagnosis (AOR = 2.22; 95% CI, 1.25–3.91, p = 0.006 ) were the risk factors for mortality among children on TB treatment. Conclusion. The study found that HIV-TB co-infected children and those clinically diagnosed with TB were significantly more likely to have had unsuccessful TB treatment outcomes and mortality. Our findings underscore the need for healthcare workers to closely monitor and support HIV-TB co-infected children on TB treatment. TB/HIV collaborative activities should be strengthened by implementing TB preventive interventions among HIV-infected children.

Background. This study was designed to assess the level of knowledge, attitude, and practice (KAP) of healthcare workers (HCWs) on pediatric TB management and its associated factors in the Centre Region of Cameroon. Methods. A cross-sectional study was conducted between January and March 2022. HCWs, selected through a multistage sampling technique in 21 health facilities, were interviewed using a KAP questionnaire on pediatric TB management. Logistic regression analyses were used to test associations between HCWs’ characteristics and knowledge, attitudes, and practice levels at a 0.05 level of significance. Results. The median age of the participants was 35 years (IQR = 30–42), and the majority (73.2%) were females. About half (50.9%) of the participants (173/340) had good knowledge, 55.6% (189/340) had a good attitude, and 57.1% (194/340) had good practice scores on pediatric TB management. Having a bachelor’s degree and above, working in the TB unit, and having received training on pediatric TB in the last five years were significantly associated with good knowledge of pediatric TB management. Similarly, having a bachelor’s degree or higher and more than five years of experience providing TB services were significantly associated with a good attitude towards pediatric TB management. Being a general practitioner, nurse, and lab technician was significantly associated with good practice in pediatric TB management. Conclusion. The level of knowledge, attitude, and practice on pediatric TB management among HCWs was suboptimal, as substantial gaps were identified. The Ministry of Health and other international organizations need to prioritize training, coaching, and mentoring support to help HCWs improve their knowledge, attitude, and practice to detect, diagnose, and treat pediatric TB.

Background Active tuberculosis (TB) case finding is important as it helps detect pulmonary TB cases missed by the other active screening methods. It requires periodic mass screening in risk population groups such as prisoners and refugees. Unfortunately, in these risk population groups periodic mass screening can be challenging due to lengthy turnaround time (TAT), cost and implementation constraints. The aim of this study was to evaluate a diagnostic algorithm that can reduce the TAT and cost for TB and Rifampicin resistance (RR) detection. The algorithm involves testing with TB-LAMP followed by Xpert MTB/RIF for positive TB-LAMP cases to diagnose TB during mass campaigns in prisons and refugee camps. Methods The National Tuberculosis Control Program (NTCP) organized routine TB mass-screening campaigns in 34 prisons and 3 villages with refugees camps in Cameroon in 2019. TB LAMP was used for initial TB diagnosis and all TB-LAMP positive cases tested with the Xpert MTB/RIF assay to determine RR. TAT and cost benefits analysis of the combined use of TB-LAMP and Xpert MTB/RIF assays was determined and compared to the Xpert MTB/RIF assay when used only. Results A total of 4075 sputum samples were collected from TB presumptive, 3672 cases in 34 prisons and 403 samples in 3 villages. Of the 4,075 samples screened with TB-LAMP, 135 were TB positive (3.31%) and run on the Xpert MTB/RIF. Of the 135 positives cases, Xpert MTB/RIF revealed 3 were RR (2.22%). The use of TB-LAMP followed by testing with Xpert MTB/RIF for TB and RR detection reduced the TAT by 73.23% in prisons and 74.92% in villages. In addition to a reduced TAT, the two molecular tests used in synergy is cost benefit from year 2 onwards. Conclusion This study demonstrates the advantages of a diagnostic algorithm based on an initial testing with TB-LAMP followed by testing with Xpert MTB/RIF for TB diagnosis. This approach improved early and rapid TB detection with an added advantage of providing RR status. The proposed algorithm is effective and less costly from the second year of implementation and should be used by TB control programs.