Factors Determining Treatment Success in Children with Drug-Sensitive Tuberculosis in Ethiopia : A Three-Year Retrospective Analysis
(2020) In American Journal of Tropical Medicine and Hygiene 103(5). p.1813-1817- Abstract
This study in the Amhara and Oromia regions of Ethiopia assessed the outcomes of tuberculosis (TB) treatment among children younger than 15 years. Retrospective data were collected on treatment outcomes and their determinants for children with TB for the cohorts of 2012-2014 enrolled in 40 hospitals and 137 health centers. Chi-square tests, t-tests, and logistic regression were used for the analysis. Of 2,557 children registered, 1,218 (47.6%) had clinically diagnosed pulmonary TB, 1,100 (43%) had extrapulmonary TB, and 277 (8.9%) had bacteriologically confirmed TB. Among all cases, 2,503 (97.9%) were newly diagnosed and 178 (7%) were HIV positive. Two-thirds of the children received directly observed treatment (DOT) in health centers... (More)
This study in the Amhara and Oromia regions of Ethiopia assessed the outcomes of tuberculosis (TB) treatment among children younger than 15 years. Retrospective data were collected on treatment outcomes and their determinants for children with TB for the cohorts of 2012-2014 enrolled in 40 hospitals and 137 health centers. Chi-square tests, t-tests, and logistic regression were used for the analysis. Of 2,557 children registered, 1,218 (47.6%) had clinically diagnosed pulmonary TB, 1,100 (43%) had extrapulmonary TB, and 277 (8.9%) had bacteriologically confirmed TB. Among all cases, 2,503 (97.9%) were newly diagnosed and 178 (7%) were HIV positive. Two-thirds of the children received directly observed treatment (DOT) in health centers and the remaining one-third, in hospitals. The treatment success rate (TSR) was 92.2%, and the death rate was 2.8%. The childhood TSR was high compared with those reported in focal studies in Ethiopia, but no national TSR report for children exists for comparison. Multivariate analysis showed that being older-5-9 years (adjusted odds ratio [AOR], 95% CI: 2.53, 1.30-4.94) and 10-14 years (AOR, 95% CI: 2.71, 1.40-5.26)-enrolled in DOT in a health center (AOR, 95% CI: 2.51, 1.82-3.48), and HIV negative (AOR, 95% CI: 1.77, 1.07-2.93) were predictors of treatment success, whereas underdosing during the intensive phase of treatment (AOR, 95% CI: 0.54, 0.36-0.82) was negatively correlated with treatment success. We recommend more research to determine if intensive monitoring of children with TB, dosage adjustment of anti-TB drugs based on weight changes, and training of health workers on dosage adjustment might improve treatment outcomes.
(Less)
- author
- publishing date
- 2020
- type
- Contribution to journal
- publication status
- published
- keywords
- Adolescent, Antitubercular Agents/therapeutic use, Child, Child, Preschool, Ethiopia/epidemiology, Female, Humans, Infant, Male, Retrospective Studies, Tuberculosis, Pulmonary/drug therapy
- in
- American Journal of Tropical Medicine and Hygiene
- volume
- 103
- issue
- 5
- pages
- 1813 - 1817
- publisher
- American Society of Tropcial Medicine & Hygiene
- external identifiers
-
- scopus:85095862229
- pmid:32959757
- ISSN
- 1476-1645
- DOI
- 10.4269/ajtmh.19-0816
- language
- English
- LU publication?
- no
- id
- c2a93f8e-93a9-4e77-91d0-15b09cbf9925
- date added to LUP
- 2021-09-08 17:45:37
- date last changed
- 2024-07-14 20:16:08
@article{c2a93f8e-93a9-4e77-91d0-15b09cbf9925,
abstract = {{<p>This study in the Amhara and Oromia regions of Ethiopia assessed the outcomes of tuberculosis (TB) treatment among children younger than 15 years. Retrospective data were collected on treatment outcomes and their determinants for children with TB for the cohorts of 2012-2014 enrolled in 40 hospitals and 137 health centers. Chi-square tests, t-tests, and logistic regression were used for the analysis. Of 2,557 children registered, 1,218 (47.6%) had clinically diagnosed pulmonary TB, 1,100 (43%) had extrapulmonary TB, and 277 (8.9%) had bacteriologically confirmed TB. Among all cases, 2,503 (97.9%) were newly diagnosed and 178 (7%) were HIV positive. Two-thirds of the children received directly observed treatment (DOT) in health centers and the remaining one-third, in hospitals. The treatment success rate (TSR) was 92.2%, and the death rate was 2.8%. The childhood TSR was high compared with those reported in focal studies in Ethiopia, but no national TSR report for children exists for comparison. Multivariate analysis showed that being older-5-9 years (adjusted odds ratio [AOR], 95% CI: 2.53, 1.30-4.94) and 10-14 years (AOR, 95% CI: 2.71, 1.40-5.26)-enrolled in DOT in a health center (AOR, 95% CI: 2.51, 1.82-3.48), and HIV negative (AOR, 95% CI: 1.77, 1.07-2.93) were predictors of treatment success, whereas underdosing during the intensive phase of treatment (AOR, 95% CI: 0.54, 0.36-0.82) was negatively correlated with treatment success. We recommend more research to determine if intensive monitoring of children with TB, dosage adjustment of anti-TB drugs based on weight changes, and training of health workers on dosage adjustment might improve treatment outcomes.</p>}},
author = {{Habte, Dereje and Tadesse, Yared and Bekele, Dereje and Alem, Genetu and Jerene, Degu and Hiruy, Nebiyu and Gashu, Zewdu and Anteneh, Tadesse and Datiko, Daniel G and Kassie, Yewulsew and Suarez, Pedro G}},
issn = {{1476-1645}},
keywords = {{Adolescent; Antitubercular Agents/therapeutic use; Child; Child, Preschool; Ethiopia/epidemiology; Female; Humans; Infant; Male; Retrospective Studies; Tuberculosis, Pulmonary/drug therapy}},
language = {{eng}},
number = {{5}},
pages = {{1813--1817}},
publisher = {{American Society of Tropcial Medicine & Hygiene}},
series = {{American Journal of Tropical Medicine and Hygiene}},
title = {{Factors Determining Treatment Success in Children with Drug-Sensitive Tuberculosis in Ethiopia : A Three-Year Retrospective Analysis}},
url = {{http://dx.doi.org/10.4269/ajtmh.19-0816}},
doi = {{10.4269/ajtmh.19-0816}},
volume = {{103}},
year = {{2020}},
}