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Factors associated with treatment failure in childhood tuberculosis
Sindhu Sivanandan1, Mandeep Walia, Rakesh Lodha
1Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India.
Insights
Extrapulmonary tuberculosis (EPTB) significantly increases treatment failure risk in children. Non-receipt of BCG vaccination and AFB positivity were also linked to poorer outcomes in this tuberculosis study.
Area of Science:
- Pediatrics
- Infectious Diseases
- Public Health
Background:
- Tuberculosis (TB) remains a significant global health challenge, particularly in pediatric populations.
- Understanding factors contributing to treatment failure is crucial for improving patient outcomes and controlling disease spread.
Purpose of the Study:
- To identify predictors of treatment failure in children diagnosed with tuberculosis.
- To analyze the association between demographic, clinical, and microbiological factors and treatment outcomes.
Main Methods:
- Retrospective review of medical records for 541 children with tuberculosis.
- Bivariate and multivariate analyses were performed to assess factors associated with treatment failure.
Main Results:
- The overall treatment failure rate was 15.5% (82 out of 541 children).
- Bivariate analysis indicated that Acid-Fast Bacilli (AFB) positivity, non-receipt of BCG vaccination, and extrapulmonary tuberculosis (EPTB) were associated with treatment failure.
- Multivariate analysis revealed that only EPTB remained a significant independent predictor of treatment failure.
Conclusions:
- Extrapulmonary tuberculosis is a key risk factor for treatment failure in children.
- Targeted interventions and closer monitoring for children with EPTB are warranted to improve treatment success rates.
Abstract:
We retrospectively reviewed records of 541 children (315 boys) suffering from tuberculosis, median age 95 (range 2-180) months, to determine factors associated with treatment failure. 256 (47.3%) children had pulmonary tuberculosis (PTB) while 285 (52.7%) had extrapulmonary tuberculosis (EPTB). 459 (84.8%) children were cured and 82 (15.5%) had treatment failure. On bivariate analysis, AFB positivity [OR= 2.13 (95% CI 1.18- 3.85)], non-receipt of BCG vaccination during infancy [OR=1.73 (1.02- 2.91)] and EPTB [1.9 (1.16- 3.11)] were associated with treatment failure. On multivariate analysis, only extrapulmonary tuberculosis was significantly associated with treatment failure.
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