Treatment outcome in children with tuberculosis in southern Ethiopia

Our study took place at 8 tuberculosis diagnostic and treatment centres in Sidama Zone, southern Ethiopia. Our objectives were to assess the status of TB treatment in children and risk factors associated with unfavourable outcome. A retrospective study was based on information retained in TB registers of the centres. Demographic characteristics and treatment outcome of children registered between 2002 and 2007 were retrieved. Risk factors for unfavourable outcome (failure, default or death) were calculated. Of 851 (165 with smear-positive, 475 smear-negative and 206 extrapulmonary TB) children, 655 (77%) were cured or completed and 124 (14.6%) had unfavourable outcome. Treatment success rate increased with age from 66% in children <5 y old to 81% in 5-9-y-olds and 85% in >/=10-y-olds (p <0.001). 75% of patients with smear-negative TB had favourable outcome compared to 80.6% for smear-positive cases (p =0.06). Age <5 y, lack of smear conversion in the second month and living in rural areas were independent risk factors for unfavourable treatment outcome. In conclusion, the outcome of TB treatment varies with age, residency and smear results. Reporting only cases with smear-positive TB disproportionally excludes a higher proportion of children than adults. Surveillance systems to monitor TB outcome in children need to be improved.