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Tuberculosis Treatment Outcomes Among Children in Rural Southern Mozambique: A 12-year Retrospective Study
Troy D Moon1,2, Edy Nacarapa3,4, M Elisa Verdu3
1From the Department of Pediatrics, Division of Pediatric Infectious Diseases.
The Pediatric Infectious Disease Journal
|October 1, 2019
Summary
Most children with tuberculosis (TB) in Mozambique had favorable treatment outcomes. Younger children and those starting TB treatment shortly after antiretroviral therapy had worse outcomes, highlighting the need for early screening and preventive therapy.
Area of Science:
- Pediatrics
- Infectious Diseases
- Public Health
Background:
- Tuberculosis (TB) significantly impacts child morbidity and mortality globally.
- Mozambique is a high-burden country for TB and TB/HIV co-infection.
- Childhood TB treatment outcomes in Mozambique require further assessment.
Purpose of the Study:
- To evaluate the treatment outcomes of childhood tuberculosis in Chókwè District, Mozambique.
- To identify factors associated with favorable TB treatment outcomes in children.
- To analyze the impact of HIV status on TB treatment outcomes in pediatric patients.
Main Methods:
- Retrospective cohort study of children under 15 years old treated for TB from 2006 to 2017.
- Descriptive statistics to characterize patient demographics and clinical data.
- Multivariable logistic regression and Kaplan-Meier curves to analyze treatment outcomes, survival, and factors influencing them.
Main Results:
- A total of 933 children with TB were included; 62% were HIV-positive.
- 83.6% of children achieved a favorable TB treatment outcome.
- Older children (5-14 years) had better outcomes and lower mortality risk compared to younger children (0-4 years).
Conclusions:
- Favorable TB treatment outcomes are achievable in most children, even in high-burden settings.
- Younger age and early initiation of TB treatment after antiretroviral therapy (ART) are associated with poorer outcomes.
- Implementing rigorous TB screening and isoniazid preventive therapy is crucial for improving outcomes in pediatric TB patients.
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