Pediatric tuberculosis in a high burden setting: Socio-spatial distribution, blood elements features, and outcomes

Area of Science:

• Global Health
• Pediatric Infectious Diseases
• Epidemiology

Background:

• Childhood tuberculosis (TB) remains a neglected epidemic requiring targeted data for effective control strategies.
• Limited data exists on pediatric TB, hindering the development of specific interventions.
• Addressing pediatric TB is crucial for overall TB eradication efforts.

Purpose of the Study:

• To analyze the socio-demographic and clinical characteristics of childhood tuberculosis cases.
• To identify factors associated with mortality and treatment outcomes in pediatric TB patients.
• To evaluate the prognostic value of hemoglobin and platelet counts in childhood TB.

Main Methods:

• Retrospective review of 200 medical records of children (0-15 years) diagnosed with TB between 2011-2021 in Libreville, Gabon.
• Analysis of socio-demographic data, including housing conditions, and clinical data.
• Statistical analysis to determine cure rates, relapse rates, mortality, and prognostic markers.

Main Results:

• 141 pediatric TB cases were analyzed; 57% were boys, with a mean age of 9.2 years.
• 60% of cases originated from precarious housing areas, highlighting a strong association.
• A cure rate of 75.24% was observed, with 15.24% mortality. Lower hemoglobin and platelet counts were significantly associated with increased mortality.
• A hemoglobin threshold of 5.5 g/dL demonstrated 80% sensitivity and 86% specificity in predicting death.

Conclusions:

• Precarious living conditions are significantly associated with childhood tuberculosis.
• Reinforcing directly observed therapy (DOTS) for older children may reduce TB-related deaths.
• Hemoglobin concentration and platelet count serve as critical prognostic indicators in pediatric tuberculosis.