[Tubeculosis in Abidjan: comparison of children and adults]

Area of Science:

• Global Health
• Infectious Diseases
• Pediatrics

Background:

• Tuberculosis (TB) is a significant global health challenge, disproportionately affecting developing nations.
• While the exact burden of childhood TB is unknown, estimates suggest children comprise 5-20% of all TB cases.
• Understanding pediatric TB is crucial for targeted public health interventions.

Purpose of the Study:

• To delineate the distinct clinical and epidemiological characteristics of tuberculosis in children compared to adult outpatients in Abidjan.
• To identify differences in disease presentation, co-infections, and treatment outcomes between pediatric and adult TB patients.

Main Methods:

• A retrospective analysis of 2617 childhood TB cases and 36,648 adult TB cases managed in Abidjan.
• Comparison of demographic data, HIV co-infection rates, TB classification (pulmonary/extrapulmonary, smear status), and treatment outcomes.
• Statistical analysis including odds ratios (OR) to assess significant differences.

Main Results:

• Children exhibited a sex ratio near parity (0.93) versus a male predominance in adults (1.50).
• HIV co-infection was less prevalent in children (24.5%) than adults (44%).
• Pediatric TB was more frequently smear-negative (65.36%) and extrapulmonary (22.76%), with lymph nodes being the most common site (30.1%).
• Treatment failure or death rates were significantly lower in children (1.9%) compared to adults (3.9%).

Conclusions:

• Tuberculosis in children in Abidjan presents with unique features, including a higher proportion of smear-negative and extrapulmonary cases, particularly lymph node involvement.
• Childhood TB is nearly equally distributed between genders and has a lower incidence of HIV co-infection compared to adult TB.
• The outcomes for childhood TB are more favorable, with significantly lower treatment failure or mortality rates than in adults.