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Childhood TB in Myanmar: trends in notification, profile and treatment outcomes in the private sector
S K Thein1, S Satyanarayana2, K W Y Kyaw3
1Department of Medical Research, Yangon, Myanmar.
Insights
Childhood tuberculosis (TB) notification rates are declining in Myanmar. The private sector plays a significant role, diagnosing and treating one in five cases with a high success rate.
Area of Science:
- Public Health
- Epidemiology
- Tuberculosis Research
Background:
- Childhood tuberculosis (TB) remains a significant global health concern.
- Understanding trends and private sector involvement is crucial for effective control strategies.
Purpose of the Study:
- To analyze trends in childhood TB notification in Myanmar from 2014-2017.
- To quantify the private sector's contribution to childhood TB notification.
- To describe the profile and treatment outcomes of childhood TB managed in the private sector.
Main Methods:
- Observational study utilizing routine records and reports from Myanmar's National Tuberculosis (TB) programme (NTP) public-private mix (PPM) projects.
- Data review from projects managed by the Myanmar Medical Association and Population Service International.
Main Results:
- Childhood TB notifications declined from 36,314 in 2014 to 28,723 in 2017.
- The private sector accounted for 17-19% of notifications.
- Of 5616 childhood TB cases treated in PPM projects in 2016, 97.7% had successful outcomes.
Conclusions:
- Childhood TB notification is decreasing in Myanmar.
- The private sector is a vital component of TB case finding and management, demonstrating high treatment success rates.
Setting:
Myanmar National Tuberculosis (TB) programme (NTP).
Objective:
To describe 1) the trends in childhood TB (aged ⩾ 14 years) notification from 2014 to 2017 and quantify the private sector contribution to this notification; and 2) the profile and treatment outcomes of childhood TB managed in the private sector in 2016.
Study Design:
This was an observational study involving the review of routine records and reports of the NTP public-private mix (PPM) projects managed by the Myanmar Medical Association and Population Service International.
Results:
The total number of childhood TB notified has declined from 36 314 in 2014 to 28 723 in 2017 (average annual decline = 2607 cases per year). The private sector contribution to the notification remained between 17% and 19%. Of the 5616 childhood TB cases diagnosed and treated under the two PPM projects in 2016, 99% were clinically diagnosed and 5459 (97.7%) had successful treatment outcomes. Children aged ⩾10 years, males, those with bacteriologically confirmed TB, those treated in the regions or states of Mandalay, Chin and Shan had a higher risk of an unfavourable outcome (lost to follow-up, death, move to second-line treatment and not evaluated).
Conclusion:
Childhood TB notification is showing a declining trend. One of five notified childhood TB cases was diagnosed and treated in the private sector, where the successful treatment rate was high.
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