Childhood tuberculosis: management and treatment outcomes among children in Northwest Ethiopia: a cross-sectional study

Abstract

IntroductionChildhood tuberculosis (TB) treatment is becoming a major challenge in the TB control efforts of the Ethiopian health system. This study assessed childhood tuberculosis management, and treatment outcomes among children who completed anti-TB treatment in Northwest Ethiopia.MethodsA cross-sectional study was conducted among children who completed their anti-TB treatment in Gondar University Referral Hospital and 6 satellite health centers. Data from each child with tuberculosis were obtained from review of medical records. P-values < 0.05 were considered statistically significant.ResultsThe commonest method of childhood TB diagnosis was clinical assessment combined with chest x-ray (48.5%). Absence of compliance with TB treatment guideline (98.7%), providing inadequate anti-TB regimen (1.8%), and poor adherence to treatment (22.5%) were challenges in management of childhood tuberculosis. Treatment success rate was 78.9%. In the bivariate regression, factors associated with TB treatment outcomes were permanent residence (OR=8.3, 95%CI: 4.1, 16.7), antiretroviral therapy (OR=4.5, 95%CI: 1.2, 16), and adherence to treatment (p < 0.001). After controlling for confounders, adherence to anti-TB treatment (OR=0.003, 95% CI: 0.001, 0.02) was independent predictor of treatment success.ConclusionAnti-tuberculosis treatment success rate was still low among children in Northwest Ethiopia. The health centers and hospital shall enhance strong follow-up of children on anti-tuberculosis treatment to improve treatment success with focus on rural children.

Paediatric Tuberculosis at the Directly Observed Treatment Short-Course Clinic of Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria

“…The successful treatment outcome was poor, far away from the WHO bench mark of 85.0% [12], which contrasts other studies that showed an overall good success rate [14,15,17,18,21,28]. However, some studies reported low treatment success rate higher than our finding which include78.0% by Oloyede et al [19], 77.4% reported by Adejumo et al [21] and 78.9% by Kebede et al [28].…”

“…DOTS have been found to be effective and efficient in treating TB [14,26,27], however, the treatment outcome in this study showed that the majority of the children were lost to follow up. This is in contrast to reports from other studies where majority of the children completed treatment [14,15,17,18,21,28]. This may be a reflection of inadequate counselling with poor adherence to medications or poor attitude by the parents resulting to lack of regular follow up to ensure completion of treatment.…”

Childhood tuberculosis treatment outcome and its association with HIV co-infection in Ethiopia: a systematic review and meta-analysis

“…The follow-up period of childhood TB treatment outcomes ranged from 1998 to 2013. Regarding the study area, one study was conducted in the Tigray region [12,17], two in Addis Ababa [16], one in Amhara [15], one in Oromia [13], and one in SNNPRS [14]. Among the included studies, four [12][13][14]16] were conducted with a retrospective cohort study design, and two [15,17] were retrospective cross-sectional.…”

Factors Determining Treatment Success in Children with Drug-Sensitive Tuberculosis in Ethiopia: A Three-Year Retrospective Analysis

“…8 The available studies of the epidemiology and treatment outcomes of childhood TB in Ethiopia have focused on a few health facilities or urban settings. 2,5,9,10 Child-specific performance data are important for understanding the situation in children, exploring the factors associated with program success, and fostering evidence-based decision-making at the policy, planning, and program implementation levels. However, the national health management information system routinely reports aggregated treatment outcomes for all age-groups.…”