Risk Factors Affecting Mortality in Children with Pulmonary Tuberculosis in Lubumbashi, Democratic Republic of the Congo

Abstract

Introduction: Childhood tuberculosis remains poorly understood and presents diagnostic and therapeutic challenges. The objective of this study was to describe the epidemiological, diagnostic and therapeutic aspects of childhood pulmonary tuberculosis in Lubumbashi in the DRC and to identify risk factors for mortality. Methods: This is a retrospective analytical study of the medical records of children (under 15 years of age) followed for pulmonary tuberculosis at the 22 centers' tuberculosis Diagnostic and Treatment during the period 1 January 2013 to 31 December 2015 in Lubumbashi. Results: 717 cases of pulmonary TB had been recorded during the study period. 377 were males and 340 were females. The mean age was 8.3 years (range: 6 months-14 years). The evolution was known for 674 children of whom 157 died (mortality rate 23.3%). In multivariate analysis, age ≤5 years (aOR=7.03 [4.36-11.35]), emaciation (aOR=2.95 [1.82-4.78]), HIV seropositivity (aOR=5.25 [3.20-8.62]), negativity by direct microscopy (aOR=2.04 [1.13-3.68]) and leukocytes ≥12000/mm3 (aOR=1.99 [1.28-3.09]) are independent predictors of mortality. Conclusion: TB is still a very severe disease with high mortality rates in children. Early recognition of infection associated with correct early treatment, systematic entourage investigation and chemoprophylaxis by isoniazide in all children under 5 years of age is essential for attempting to reduce these prognostic indices.