High caseload of childhood tuberculosis in hospitals on Java Island, Indonesia: a cross sectional study

Area of Science:

• Pediatrics
• Infectious Diseases
• Public Health

Background:

• Childhood tuberculosis (TB) remains a neglected area within global TB control efforts.
• The burden of pediatric TB in Indonesian hospitals was largely unquantified despite the implementation of Directly Observed Treatment Shortcourse (DOTS) programs.
• This study aimed to characterize the caseload and types of childhood TB diagnosed in DOTS hospitals on Java Island.

Purpose of the Study:

• To document the incidence and types of childhood TB in Indonesian hospitals.
• To analyze TB cases in children aged 0-4 and 5-14 years.
• To identify gaps in TB recording and reporting for pediatric cases.

Main Methods:

• A cross-sectional study analyzing TB cases from inpatient and outpatient registers of 32 hospitals in Indonesia.
• Data were categorized by hospital characteristics, age groups (0-4 and 5-14 years), and TB types (smear-positive, extra-pulmonary).
• Comparison of reported cases between outpatient units and TB registers, and reporting to the National TB Program.

Main Results:

• Children constituted 11% of inpatient and 27% of outpatient TB cases, with most under five years old.
• Smear-positive TB was more prevalent in inpatients (15.6%) than outpatients (8.1%).
• Extra-pulmonary TB represented 15% of inpatient and 6% of outpatient cases, with only 1.6% of hospital-diagnosed childhood TB reported nationally.

Conclusions:

• High caseloads and under-reporting of childhood TB necessitate increased priority for pediatric case management in DOTS hospitals.
• There is a critical need for international guidelines on childhood TB recording and reporting.
• Improved diagnostics and standardized classification are essential for accurate pediatric TB management.