The burden and outcomes of childhood tuberculosis in Cotonou, Benin

Area of Science:

• Pediatric infectious diseases
• Public health epidemiology
• Global health security

Background:

• Tuberculosis (TB) remains a significant global health challenge, particularly affecting vulnerable populations like children.
• Accurate diagnosis and effective treatment of childhood TB are crucial for reducing morbidity and mortality.
• Limited data exists on the specific burden and outcomes of pediatric TB in many low-resource settings.

Purpose of the Study:

• To describe the burden, characteristics, and treatment outcomes of pediatric tuberculosis (TB) cases in Cotonou, Benin.
• To identify challenges in the diagnosis and management of TB in children under 15 years old.
• To inform strategies for improving pediatric TB control in similar settings.

Main Methods:

• A cross-sectional cohort study was conducted using a retrospective review of medical records.
• Data was collected on all children diagnosed with TB aged less than 15 years treated between 2009 and 2011.
• The study included cases managed by the National Tuberculosis Programme (NTP) and the General Hospital (GH).

Main Results:

• 182 children were diagnosed with TB, representing 4.5% of all TB cases; 84% were managed by the NTP.
• The incidence rate of notified TB cases ranged from 8 to 13 per 100,000 population, higher in children over 5 years.
• Overall treatment success was 72%, with lower rates for sputum smear-negative (62%) and HIV-coinfected children (58%).

Conclusions:

• Childhood TB is underdiagnosed, especially in younger children, indicating a need for improved diagnostic approaches.
• Treatment outcomes for pediatric TB are suboptimal, particularly for HIV-coinfected children, highlighting the need for enhanced follow-up and monitoring.
• Strengthening TB case-finding and management in children is essential for effective TB control programs.