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Correlates of tuberculosis in children under the age of 15 years
Lukundo Siame1, Gift C Chama1, Sepiso K Masenga1
1School of Medicine and Health Sciences, Mulungushi University, Livingstone, Zambia.
Insights
In Zambia, 9.4% of hospitalized children under 15 had active tuberculosis (TB). HIV and malnutrition significantly increased the risk of TB in these children.
Area of Science:
- Pediatrics
- Public Health
- Infectious Diseases
Background:
- Tuberculosis (TB) is a major global health issue, especially impacting children in Sub-Saharan Africa.
- Zambia faces a high burden of TB, with limited data on pediatric cases.
- This study addresses the knowledge gap regarding childhood TB in Zambia.
Purpose of the Study:
- To determine the prevalence of active TB in hospitalized children under 15 years old in Zambia.
- To identify sociodemographic and clinical factors associated with active TB disease in this pediatric population.
Main Methods:
- A retrospective cross-sectional study analyzed data from 700 pediatric patients under 15 at Livingstone University Teaching Hospital.
- Systematic sampling and programmatic data from medical records were used.
- Statistical analyses included descriptive statistics, chi-square tests, and multivariable logistic regression.
Main Results:
- The prevalence of active TB was 9.4% among hospitalized children.
- Children living with HIV had a 6.30 times higher likelihood of active TB.
- Malnourished children had a 10.38 times higher likelihood of active TB.
Conclusions:
- Active TB affects 9.4% of hospitalized children under 15 in this Zambian setting.
- HIV infection and malnutrition are significant risk factors for active TB in children.
- Targeted pediatric TB control strategies in Zambia must address HIV and malnutrition.
Background:
Tuberculosis (TB) remains a significant public health challenge, particularly among vulnerable populations like children. This is especially true in Sub-Saharan Africa, where the burden of TB in children is substantial. Zambia ranks 21st among the top 30 high TB endemic countries globally. While studies have explored TB in adults in Zambia, the prevalence and associated factors in children are not well documented. This study aimed to determine the prevalence and sociodemographic, and clinical factors associated with active TB disease in hospitalized children under the age of 15 years at Livingstone University Teaching Hospital (LUTH), the largest referral center in Zambia's Southern Province.
Methods:
This retrospective cross-sectional study of 700 pediatric patients under 15 years old, utilized programmatic data from the Pediatrics Department at LUTH. A systematic sampling method was used to select participants from medical records. Data on demographics, medical conditions, anthropometric measurements, and blood tests were collected. Data analysis included descriptive statistics, chi-square tests, and multivariable logistic regression to identify factors associated with TB.
Results:
The median age was 24 months (interquartile range (IQR): 11, 60) and majority were male (56.7%, n = 397/700). Most participants were from urban areas (59.9%, n = 419/700), and 9.2% (n = 62/675) were living with HIV. Malnutrition and comorbidities were present in a significant portion of the participants (19.0% and 25.1%, respectively). The prevalence of active TB cases was 9.4% (n = 66/700) among hospitalized children. Persons living with HIV (Adjusted odds ratio (AOR) of 6.30; 95% confidence interval (CI) of 2.85, 13.89, p< 0.001), and those who were malnourished (AOR: 10.38, 95% CI: 4.78, 22.55, p< 0.001) had a significantly higher likelihood of developing active TB disease.
Conclusion:
This study revealed a prevalence 9.4% active TB among hospitalized children under 15 years at LUTH. HIV status and malnutrition emerged as significant factors associated with active TB disease. These findings emphasize the need for pediatric TB control strategies that prioritize addressing associated factors to effectively reduce the burden of tuberculosis in Zambian children.
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