Related Experiment Video
Updated: Jan 25, 2026
Analysis of 18FDG PET/CT Imaging as a Tool for Studying Mycobacterium tuberculosis Infection and Treatment in Non-human Primates
Published on: September 5, 2017
Outcomes of empiric treatment for pediatric tuberculosis, Kampala, Uganda, 2010-2015
Eric Wobudeya1, Devan Jaganath2, Moorine Penninah Sekadde3
1Directorate of Pediatrics & Child Health, Mulago National Referral Hospital, P.O. Box 23491, Kampala, Uganda. ewobudeya@gmail.com.
Insights
Empiric treatment for childhood tuberculosis (TB) in Uganda was effective and safe for most children. However, improving care retention and managing co-morbidities are crucial to reach the 90% treatment success target.
Area of Science:
- Pediatric infectious diseases
- Global health
- Tuberculosis research
Background:
- Childhood tuberculosis (TB) diagnoses often lack microbiologic confirmation, necessitating empiric treatment.
- Concerns regarding poor outcomes and adverse effects can be barriers to initiating empiric TB treatment in children.
- This study evaluated the outcomes of empiric TB treatment in a pediatric cohort at a national referral hospital in Kampala, Uganda.
Purpose of the Study:
- To determine the outcomes of empiric tuberculosis treatment in children.
- To identify factors associated with unfavorable outcomes, including loss to follow-up and death.
Main Methods:
- Retrospective cohort study of 516 children diagnosed clinically with TB between 2010 and 2015.
- Data extraction from patient charts included demographics, clinical data, treatment outcomes, and adverse events.
- Logistic regression analysis was used to assess factors associated with loss to follow-up and death.
Main Results:
- A majority of children (82%) experienced a favorable outcome, completing treatment with clinical improvement and without treatment-discontinuing adverse events.
- Unfavorable outcomes included loss to follow-up (61% of unfavorable outcomes) and death (37% of unfavorable outcomes, 7% overall mortality).
- Factors associated with loss to follow-up included older age, HIV positivity, hospitalization, and living outside Kampala. Death was associated with hospitalization, severe malnutrition, hepatomegaly, and living outside Kampala.
Conclusions:
- Empiric treatment for childhood TB in this Ugandan cohort was effective and safe.
- Treatment success rates, while high, remained below the target of 90%.
- Addressing co-morbidities and enhancing patient retention in care are key strategies to improve outcomes in childhood TB.
Background:
Childhood tuberculosis (TB) diagnoses often lack microbiologic confirmation and require empiric treatment. Barriers to empiric treatment include concern for poor outcomes and adverse effects. We thus determined the outcomes of empiric TB treatment from a retrospective cohort of children at a national referral hospital in Kampala, Uganda from 2010 to 2015.
Methods:
Children were diagnosed clinically and followed through treatment. Demographics, clinical data, outcome and any adverse events were extracted from patient charts. A favorable outcome was defined as a child completing treatment with clinical improvement. We performed logistic regression to assess factors associated with loss to follow up and death.
Results:
Of 516 children, median age was 36 months (IQR 15-73), 55% (95% CI 51-60%) were male, and HIV prevalence was 6% (95% CI 4-9%). The majority (n = 422, 82, 95% CI 78-85%) had a favorable outcome, with no adverse events that required treatment discontinuation. The most common unfavorable outcomes were loss to follow-up (57/94, 61%) and death (35/94, 37%; overall mortality 7%). In regression analysis, loss to follow up was associated with age 10-14 years (OR 2.38, 95% CI 1.15-4.93, p = 0.02), HIV positivity (OR 3.35, 95% CI 1.41-7.92, p = 0.01), hospitalization (OR 4.14, 95% CI 2.08-8.25, p < 0.001), and living outside of Kampala (OR 2.64, 95% CI 1.47-4.71, p = 0.001). Death was associated with hospitalization (OR 4.57, 95% CI 2.0-10.46, p < 0.001), severe malnutrition (OR 2.98, 95% CI 1.07-8.27, p = 0.04), baseline hepatomegaly (OR 4.11, 95% CI 2.09-8.09, p < 0.001), and living outside of Kampala (OR 2.41, 95% CI 1.17-4.96, p = 0.02).
Conclusions:
Empiric treatment of child TB was effective and safe, but treatment success remained below the 90% target. Addressing co-morbidities and improving retention in care may reduce unfavorable outcomes.
Related Concept Videos
01:09Empirical Method to Interpret Standard Deviation
This rule is used widely in statistics to calculate the proportion of data values...
02:24Predicting Reaction Outcomes
01:13Outcomes of Glycolysis
Cellular respiration can occur aerobically (with oxygen) or anaerobically (without oxygen). In the presence of oxygen, cellular respiration starts with glycolysis and continues with pyruvate...
01:29Pulmonary Tuberculosis I
Causative Organism
The primary infectious agent causing tuberculosis is Mycobacterium tuberculosis, a slow-growing, acid-fast, aerobic rod that exhibits sensitivity to heat and ultraviolet light. Instances of Mycobacterium bovis and Mycobacterium avium contributing to the development of TB infection are rare.
Mode of...
01:28Pulmonary Tuberculosis II
Here is a detailed explanation of its pathophysiology:
Transmission: The process begins when a person inhales droplet nuclei containing M. tuberculosis. These are typically released into the air when an individual with pulmonary or...
01:28Pulmonary Tuberculosis V
Latent tuberculosis infection occurs when TB bacteria are present in a person's body, but are not causing illness or symptoms. It is not contagious, and preventive treatment is crucial to avoid the...