Risk factors for unsuccessful tuberculosis treatment outcomes in children


Autoři: Meherunissa Hamid aff001;  Meredith B. Brooks aff002;  Falak Madhani aff001;  Hassan Ali aff001;  Mohammad Junaid Naseer aff0010;  Mercedes Becerra aff002;  Farhana Amanullah aff001
Působiště autorů: Global Health Directorate, The Indus Health Network, Karachi, Sindh, Pakistan aff001;  Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, United States of America aff002;  Department of Pediatrics, The Indus Hospital, Karachi, Sindh, Pakistan aff003
Vyšlo v časopise: PLoS ONE 14(9)
Kategorie: Research Article
doi: 10.1371/journal.pone.0222776

Souhrn

Objective

Pakistan has a high pediatric burden of tuberculosis, but few studies describe the treatment experience of children with tuberculosis in Pakistan. We sought to identify risk factors for unsuccessful treatment outcomes in children with drug-susceptible tuberculosis identified in eight hospitals in Karachi, Pakistan.

Design

We conducted a retrospective cohort study among children (<15 years old) treated with first-line anti-tuberculosis drugs for presumed or confirmed drug-susceptible tuberculosis between 2016 and 2017. We assessed risk factors for experiencing an unsuccessful treatment outcome through multivariable logistic regression analysis.

Results

In total, 1,665 children initiated tuberculosis treatment, including 916 (55.0%) identified through intensified case finding. Unsuccessful treatment outcomes were experienced by 197 (11.8%) children, comprising 27 (1.6%) deaths, 16 (1.0%) treatment failures, and 154 (9.3%) lost to follow-up. An additional 47 (2.8%) children had outcomes not evaluable. In multivariable analysis, children 0–4 years old (OR: 1.80, 95% CI: 1.07–3.04), males (OR: 1.48, 95% CI: 1.04, 2.11), and those with bacteriologic confirmation of disease (OR: 3.39, 95% CI: 1.98, 5.80) had increased odds of experiencing an unsuccessful treatment outcome.

Conclusion

Our findings suggest a need to deploy strategies to identify children earlier in the disease process and point to the need for interventions tailored for young children once treatment is initiated.

Klíčová slova:

Bacterial pathogens – Drug therapy – Child health – Children – Medical risk factors – Sputum – Tuberculosis – Tuberculosis diagnosis and management


Zdroje

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Článek vyšel v časopise

PLOS One


2019 Číslo 9

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