Pattern and Outcome of Childhood Tuberculosis Seen at the University of Port Harcourt Teaching Hospital, Nigeria

Alex-Hart, B. A.; Paul, Nsirimobu Ichendu

doi:10.4236/jtr.2019.73017

Cited by 4 publications

(1 citation statement)

References 24 publications

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“…It found that there was no difference in treatment outcome of TB among different subgroups of EPTB (TB lymphadenitis and pleural effusion). This was in line with the study conducted in Nigeria ( 33 ). But this different with study conducted in Kinshasa Zaire which reported low treatment rate completion among children with TB lymph node (67.8%) ( 34 ).…”

Section: Discussionsupporting

confidence: 92%

Treatment outcome of pediatric tuberculosis in eastern Ethiopia

et al. 2022

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BackgroundChildren are more vulnerable to developing active Mycobacterium tuberculosis infection which causes significant morbidity and mortality. However, the contribution of childhood tuberculosis and its treatment outcomes have not been well documented, and no research has been conducted in eastern Ethiopia.ObjectiveThis study aimed to assess the treatment outcome and its predictors of pediatric tuberculosis in eastern Ethiopia from September 1, 2017 to January 30, 2018.MethodsA retrospective study was conducted in eight selected hospitals in eastern Ethiopia. Data on 2002 children with tuberculosis was extracted by using the standard checklist of the national tuberculosis treatment format. Treatment outcomes were determined according to the standard definitions of the National Tuberculosis and Leprosy Control Programme. Data were entered into Epi Data software version 3.1 and exported to Statistical Package for Social Science (SPSS) version 20 for analysis. Bivariable and multivariable regression analyses were carried out to examine the associations between dependent and independent variables. A P-value of <0.05 was considered statistically significant.ResultThe overall successful treatment rate was 1,774 (88.6%) [95% confidence interval (CI): (80.59–97.40)]. A total of 125 (6.2%), 1,648 (82.3%), 59 (2.9%), and 19 (0.9%) children with tuberculosis (TB) were cured, completed, defaulted, and died, respectively. A high number of defaulters and deaths were reported in the age group <10 years. More children with smear-positive pulmonary TB (74.4%) were cured, while smear-negative tuberculosis had higher treatment completion rates. Being male in sex (adjusted odds ratio (AOR): 0.71, 95% CI: 0.53, 0.96) and those with human immunodeficiency virus (HIV) positive sero status (AOR: 0.51, 95% CI: 0.29, 0.90) had a lower chance of a successful treatment outcome.ConclusionIn this study, thee treatment success rate was higher than the recent World Health Organization report. Those males and HIV seropositive status were less likely to have a successful treatment outcome. Therefore, efforts should be made by each health institution in eastern Ethiopia by giving emphasis on male and HIV-positive individuals.

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Section: Discussionsupporting

confidence: 92%

Treatment outcome of pediatric tuberculosis in eastern Ethiopia

et al. 2022

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Prevalence, clinical characteristics, and treatment outcomes of childhood tuberculosis in Nigeria: a systematic review and meta-analysis

Ukoaka,

Daniel,

Wagwula

et al. 2024

BMC Infect Dis

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Background Tuberculosis (TB), caused by Mycobacterium tuberculosis , is a leading cause of infection-related deaths worldwide. Children with underdeveloped immune systems are particularly vulnerable, experiencing symptoms akin to common childhood illnesses. Early diagnosis and treatment typically yield positive outcomes. In Nigeria, childhood TB is underreported, complicating accurate burden assessment. This review synthesises and presents evidence on the disease prevalence among children in Nigeria, identifies clinical characteristics, and evaluates the effectiveness of treatment regimens and outcomes. Methodology A comprehensive systematic search across electronic databases was conducted to retrieve studies on the prevalence, characteristics, diagnostic criteria, and treatment outcomes of childhood tuberculosis in Nigeria. Study registration, data extraction and quality assessment followed standardized guidelines. The meta-analysis used a random-effects model to determine prevalence and mean treatment outcomes. Statistical heterogeneity was assessed using the I² statistic, and publication bias was evaluated with Egger’s test ( p = 0.127) and a funnel plot. Results This review and meta-analysis of 22 studies, primarily retrospective (77%) and cross-sectional (18.20%), involving 1,162,936 participants aged 0–18 years, found a pooled prevalence of 20.82% (95% CI: 8.55–36.64)) with high heterogeneity (I 2 = 99.88%). Pulmonary tuberculosis is the most common form in children 62.70% (95%: 43.57–80.03) diagnosed using sputum smear microscopy, GeneXpert MTB/RIF assays, chest radiographs, and tuberculin skin tests. Clinical diagnosis based on symptoms, contact history, and radiological findings is crucial for younger children unable to produce sputum, as laboratory tests confirm only 6% of cases. Treatment involves the use of rifampicin, isoniazid, pyrazinamide, and ethambutol per national and international guidelines. The meta-analysis showed an average treatment success rate of 75.47%%, but challenges such as loss to follow-up (11.40%)) and increasing mortality rates (6.76%) persist. Conclusion The burden of childhood tuberculosis in Nigeria is significant, even as diagnostic limitations pose constraints. The findings highlight the need for stronger health system collaborations to improve the quality of care offered to children diagnosed with TB. Future research should standardize diagnostic criteria and methodologies for consistent and reliable prevalence estimates. More longitudinal studies are necessary to comprehend the trend and pattern for the heightened prevalence and subpar treatment outcomes of childhood tuberculosis in Nigeria. PROSPERO ID CRD42024586765. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-024-10321-3....

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Childhood tuberculosis outcomes and factors associated with unsuccessful treatment outcomes in selected public hospitals of Lusaka Zambia from 2015 to 2019

Ngosa,

Lupenga

2024

PLOS Glob Public Health

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Treatment outcomes of tuberculosis in children are rarely evaluated. Childhood tuberculosis has been a low priority for tuberculosis programs due to difficulties in diagnosis and treatment. This study evaluated childhood tuberculosis outcomes and factors associated with unsuccessful treatment outcomes in selected public hospitals in Lusaka, Zambia from 2015 to 2019. This was a cross-sectional study conducted in eight public hospitals in Lusaka. All children aged 0–14 years, treated with tuberculosis and had treatment outcomes evaluated were included. The WHO tuberculosis treatment outcomes were grouped into successful treatment outcome (cured, treatment completed) and unsuccessful treatment outcome (death, loss to follow-up, failure). Taking unsuccessful treatment outcome as the outcome variable, logistic regression models were performed. All analyses were done at a 95% confidence interval. Out of 2,531 children managed for TB from 2015 to 2019, only 1,495 (59.1%) had treatment outcomes evaluated. Out of 1,495 participants, majority were 5 to 14 years old (50.9%), males (51.1%), HIV-negative (58.7%), and had pulmonary tuberculosis (74.2%). Bacteriological tests were performed on 59.8% of children, where 21.6% had positive bacteriological results. Bacteriologically confirmed TB was higher in children over 5 years (29.5%), pulmonary TB (25.6%), and retreatment (28.6%). The majority of children (84.2%) completed treatment, while 10.7% were cured, 1.5% were lost to follow-up, 3.1% died, and 0.5% failed treatment. Overall, unsuccessful treatment outcome was 5.1% while successful treatment outcome was 94.1%. Extrapulmonary tuberculosis was associated with unsuccessful treatment outcomes (AOR 1.64; 95% CI: 1.02–2.62). The tuberculosis successful treatment outcome met the World Health Organization’s threshold goal of 90%. Children with extrapulmonary tuberculosis should be targeted as a high-risk group to improve treatment outcomes. Tracking children whose treatment outcomes were not evaluated would provide more precise estimates of TB treatment outcomes.

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Pattern and Outcome of Childhood Tuberculosis Seen at the University of Port Harcourt Teaching Hospital, Nigeria

Cited by 4 publications

References 24 publications

Treatment outcome of pediatric tuberculosis in eastern Ethiopia

Treatment outcome of pediatric tuberculosis in eastern Ethiopia

Prevalence, clinical characteristics, and treatment outcomes of childhood tuberculosis in Nigeria: a systematic review and meta-analysis

Childhood tuberculosis outcomes and factors associated with unsuccessful treatment outcomes in selected public hospitals of Lusaka Zambia from 2015 to 2019

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