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Outcomes in children treated for tuberculosis with the new dispersible fixed-dose combinations in Port Moresby

V Apis1, M Landi1,2, S M Graham3,4,5

  • 1Port Moresby General Hospital, Port Moresby, Papua New Guinea (PNG).

Public Health Action
|October 4, 2019
PubMed

Insights

New fixed-dose combinations (FDCs) for pediatric tuberculosis (TB) treatment in Papua New Guinea showed favorable outcomes in 60% of children. Malnutrition increased loss to follow-up (LTFU) risk, highlighting the need for improved care models.

Area of Science:

  • Pediatric infectious diseases
  • Global health
  • Pharmacology

Background:

  • Fixed-dose combinations (FDCs) were introduced in 2016 for first-line treatment of children (<15 years, <25 kg) with tuberculosis (TB) in Papua New Guinea.
  • This initiative aimed to improve treatment adherence and efficacy in a pediatric population with high TB burden.

Purpose of the Study:

  • To characterize children receiving new FDCs for TB treatment.
  • To evaluate treatment outcomes in this cohort.
  • To identify risk factors associated with unfavorable treatment outcomes, particularly loss to follow-up (LTFU).

Main Methods:

  • Retrospective cohort study analyzing data from August 2016 to August 2017.
  • Inclusion criteria: children (<15 years, <25 kg) treated with FDCs for TB.
  • Data collected on diagnosis, human immunodeficiency virus (HIV) status, nutritional status, and treatment outcomes.

Main Results:

  • 713 children were included; 68% had pulmonary TB.
  • Only 0.8% of TB cases were bacteriologically confirmed; HIV status was known for 50%.
  • Favorable outcomes were observed in 60% of children. Loss to follow-up (LTFU) was high (84% of unfavorable outcomes), and 8.4% died. Severely underweight children had a higher risk of LTFU (aRR 1.3).

Conclusions:

  • Significant challenges remain in microbiological confirmation of TB and HIV status.
  • High rates of LTFU underscore the need for alternative care models, potentially integrating nutritional support.
  • Addressing malnutrition is crucial to improve treatment outcomes for children with TB.
Abstract

Keywords:
child tuberculosisloss to follow-upoutcomestreatment

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