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Risk Factors of Childhood Tuberculosis in the Centre Region of Cameroon: An Unmatched Case-Control Study
Thomas Achombwom Vukugah1, Derick Akompab Akoku2, Micheline Mekemnang Tchoupa3
1ICAP in Cameroon, Mailman School of Public Health, Columbia University, Yaounde, Cameroon, columbia.edu.
Background:
Even though childhood tuberculosis (TB) is of public health significance in Cameroon, reports on childhood TB and its risk factors are limited. The objective of this study was to identify the risk factors for TB among children in the Centre Region, Cameroon.
Methods:
An unmatched case-control study was conducted at ten health facilities in the Centre Region from February 12 to July 31, 2022. Children under 15 years who attended these health facilities for TB treatment were considered as cases. Controls were children attendees who presented in the outpatient department (OPD) of the same health facility for non-TB health problems. For each case, two consecutive controls were sampled systematically. Data were collected using pretested and structured questionnaires through face-to-face interviews with parents/guardians. Logistic regression analyses were employed to identify risk factors for TB.
Results:
A total of 120 cases and 231 controls were enrolled in the study, and the median (interquartile range) age among both cases and control was 3 years (IQR = 1-3). The odds of TB were seven times (AOR = 7.24; 95% CI: 1.76-18.98) more likely among children with the absence of BCG vaccination compared with being vaccinated for BCG. A child's previous history of TB, family history with a TB patient, duration of contact with a TB patient, and child's HIV status were the other risk factors of childhood TB with AOR 20.01 (4.77-33.87), 4.90 (1.10-21.83), 4.76 (1.02-12.14), and 2.73 (1.55-19.10), respectively.
Conclusion:
The absence of BCG vaccination, the child's previous history of TB, family history with a TB patient, duration of contact with a TB patient, and HIV-positive status are the independent risk factors for childhood TB in the Centre Region. Contact tracing and contact screening should be enhanced and correctly implemented by the National TB Control Program.
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