[Epidemiology of childhood tuberculosis in Libreville, Gabon from 1997 to 2001]

The purpose of this retrospective study was to determine the epidemiological features of tuberculosis patients under the age of 15 years treated at the Tuberculosis Control Center in Libreville, Gabon from 1997 to 2001 as a basis for improving management. Study criteria included age, sex, BCG vaccination status, social level, type of tuberculosis, HIV status and outcome of treatment. Statistical analysis was performed using EPI INFO software. The childhood tuberculosis rate was 9% with a sex ratio of 1.02 and the most common age group was 0 to 4 years. Three fourths of children were from poor zones and 90% had received BCG vaccination. The incidence of tuberculosis did not increase from year to year. The location of tuberculosis was pulmonary in 77% of cases (n=433) and extrapulmonary in 23% (n=129). No case involving meningitis or miliary disease was observed. Sputum bacilloscopy was positive in 21% of cases involving pulmonary tuberculosis and HIV serology was positive in 4.4% of children tested. The success rate was 54%. Tuberculosis-related mortality was 0.7% but 37% of children were lost from follow-up. Efforts to control tuberculoses by screening children exposed to bacilliferous conditions and vaccinating newborns must be continued. Treatment for tuberculosis must be given free of charge and under medical supervision as recommended by the World Health Organization.