Pediatric tuberculosis outcomes and factors associated with unfavorable treatment outcomes in Botswana, 2008–2019: a retrospective analysis
Abstract Introduction Globally, the amount of research on the outcomes of pediatric tuberculosis (TB) is disproportionately less than that of adult TB. The diagnosis of paediatric TB is also problematic in developing countries. The aim of this study was to describe the outcomes of pediatric TB in Bo...
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| Language: | English |
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BMC
2022-11-01
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| Series: | BMC Public Health |
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| Online Access: | https://doi.org/10.1186/s12889-022-14477-y |
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| author | Keatlaretse Siamisang Goabaone Rankgoane-Pono Tumisang Malebo Madisa Tantamika Kabamba Mudiayi John Thato Tlhakanelo Paul Mubiri Khutsafalo Kadimo Francis Msume Banda Vincent Setlhare |
| author_facet | Keatlaretse Siamisang Goabaone Rankgoane-Pono Tumisang Malebo Madisa Tantamika Kabamba Mudiayi John Thato Tlhakanelo Paul Mubiri Khutsafalo Kadimo Francis Msume Banda Vincent Setlhare |
| author_sort | Keatlaretse Siamisang |
| collection | DOAJ |
| description | Abstract Introduction Globally, the amount of research on the outcomes of pediatric tuberculosis (TB) is disproportionately less than that of adult TB. The diagnosis of paediatric TB is also problematic in developing countries. The aim of this study was to describe the outcomes of pediatric TB in Botswana and to identify the factors associated with unfavorable outcomes. Methods This was a retrospective analysis of pediatric TB outcomes in Botswana, over a 12-year period from January 2008 to December 2019. Treatment success (treatment completion or cured) was considered a favorable outcome, while death, loss to follow-up and treatment failure were considered unfavorable outcomes. Program data from drug-sensitive TB (DS-TB) cases under the age of 15 years were included. Sampling was exhaustive. Binary logistic regression was used to determine the factors associated with unfavorable outcomes during TB treatment. A p value of < 0.05 was considered a statistically significant association between the predictor variables and unfavorable outcomes. Results The data of 6,004 paediatric TB cases were extracted from the Botswana National TB Program (BNTP) electronic registry and analyzed. Of these data, 2,948 (49.4%) were of female patients. Of the extracted data, 1,366 (22.8%) were of HIV positive patients and 2,966 (49.4%) were of HIV negative patients. The rest of the data were of patients with unknown HIV status. Pulmonary TB accounted for 4,701 (78.3%) of the cases. Overall, 5,591 (93.1%) of the paediatric TB patient data showed treatment success, 179 (3.0%) were lost to follow-up, 203 (3.4%) records were of patients who died, and 31 (0.5%) were of patients who experienced treatment failure. The factors associated with unfavorable outcomes were positive HIV status (AOR 2.71, 95% CI: 2.09–3.52), unknown HIV status (AOR 2.07, 95% CI: 1.60–2.69) and retreatment category (AOR 1.92, 95% CI: 1.30–2.85). Compared with the 0–4 years age category, the 5–9 years (AOR 0.62, 95% CI: 0.47–0.82) and 10–14 years (AOR 0.76, 95% CI: 0.60–0.98) age categories were less likely to experience the unfavorable outcomes. Conclusion This study shows a high treatment success rate among paediatric TB cases in Botswana. The government under the National TB Program should maintain and consolidate the gains from this program. Public health interventions should particularly target children with a positive or unknown HIV status, those under 5 years, and those who have been previously treated for TB. |
| first_indexed | 2024-04-11T23:04:43Z |
| format | Article |
| id | doaj.art-1f0c933440844a91a902e6a759480b36 |
| institution | Directory Open Access Journal |
| issn | 1471-2458 |
| language | English |
| last_indexed | 2024-04-11T23:04:43Z |
| publishDate | 2022-11-01 |
| publisher | BMC |
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| series | BMC Public Health |
| spelling | doaj.art-1f0c933440844a91a902e6a759480b362022-12-22T03:58:02ZengBMCBMC Public Health1471-24582022-11-012211810.1186/s12889-022-14477-yPediatric tuberculosis outcomes and factors associated with unfavorable treatment outcomes in Botswana, 2008–2019: a retrospective analysisKeatlaretse Siamisang0Goabaone Rankgoane-Pono1Tumisang Malebo Madisa2Tantamika Kabamba Mudiayi3John Thato Tlhakanelo4Paul Mubiri5Khutsafalo Kadimo6Francis Msume Banda7Vincent Setlhare8Department of Family Medicine and Public Health, University of BotswanaDepartment of Family Medicine and Public Health, University of BotswanaDepartment of Health Services Management, Ministry of HealthDepartment of Health Services Management, Ministry of HealthDepartment of Family Medicine and Public Health, University of BotswanaMaryland Global Initiative Corporation (MGIC), University of Maryland, Baltimore (UMB)Department of Library Services, University of BotswanaDepartment of Pediatrics, University of BotswanaDepartment of Family Medicine and Public Health, University of BotswanaAbstract Introduction Globally, the amount of research on the outcomes of pediatric tuberculosis (TB) is disproportionately less than that of adult TB. The diagnosis of paediatric TB is also problematic in developing countries. The aim of this study was to describe the outcomes of pediatric TB in Botswana and to identify the factors associated with unfavorable outcomes. Methods This was a retrospective analysis of pediatric TB outcomes in Botswana, over a 12-year period from January 2008 to December 2019. Treatment success (treatment completion or cured) was considered a favorable outcome, while death, loss to follow-up and treatment failure were considered unfavorable outcomes. Program data from drug-sensitive TB (DS-TB) cases under the age of 15 years were included. Sampling was exhaustive. Binary logistic regression was used to determine the factors associated with unfavorable outcomes during TB treatment. A p value of < 0.05 was considered a statistically significant association between the predictor variables and unfavorable outcomes. Results The data of 6,004 paediatric TB cases were extracted from the Botswana National TB Program (BNTP) electronic registry and analyzed. Of these data, 2,948 (49.4%) were of female patients. Of the extracted data, 1,366 (22.8%) were of HIV positive patients and 2,966 (49.4%) were of HIV negative patients. The rest of the data were of patients with unknown HIV status. Pulmonary TB accounted for 4,701 (78.3%) of the cases. Overall, 5,591 (93.1%) of the paediatric TB patient data showed treatment success, 179 (3.0%) were lost to follow-up, 203 (3.4%) records were of patients who died, and 31 (0.5%) were of patients who experienced treatment failure. The factors associated with unfavorable outcomes were positive HIV status (AOR 2.71, 95% CI: 2.09–3.52), unknown HIV status (AOR 2.07, 95% CI: 1.60–2.69) and retreatment category (AOR 1.92, 95% CI: 1.30–2.85). Compared with the 0–4 years age category, the 5–9 years (AOR 0.62, 95% CI: 0.47–0.82) and 10–14 years (AOR 0.76, 95% CI: 0.60–0.98) age categories were less likely to experience the unfavorable outcomes. Conclusion This study shows a high treatment success rate among paediatric TB cases in Botswana. The government under the National TB Program should maintain and consolidate the gains from this program. Public health interventions should particularly target children with a positive or unknown HIV status, those under 5 years, and those who have been previously treated for TB.https://doi.org/10.1186/s12889-022-14477-yPediatricTuberculosisOutcomesAssociated factorsBotswana |
| spellingShingle | Keatlaretse Siamisang Goabaone Rankgoane-Pono Tumisang Malebo Madisa Tantamika Kabamba Mudiayi John Thato Tlhakanelo Paul Mubiri Khutsafalo Kadimo Francis Msume Banda Vincent Setlhare Pediatric tuberculosis outcomes and factors associated with unfavorable treatment outcomes in Botswana, 2008–2019: a retrospective analysis BMC Public Health Pediatric Tuberculosis Outcomes Associated factors Botswana |
| title | Pediatric tuberculosis outcomes and factors associated with unfavorable treatment outcomes in Botswana, 2008–2019: a retrospective analysis |
| title_full | Pediatric tuberculosis outcomes and factors associated with unfavorable treatment outcomes in Botswana, 2008–2019: a retrospective analysis |
| title_fullStr | Pediatric tuberculosis outcomes and factors associated with unfavorable treatment outcomes in Botswana, 2008–2019: a retrospective analysis |
| title_full_unstemmed | Pediatric tuberculosis outcomes and factors associated with unfavorable treatment outcomes in Botswana, 2008–2019: a retrospective analysis |
| title_short | Pediatric tuberculosis outcomes and factors associated with unfavorable treatment outcomes in Botswana, 2008–2019: a retrospective analysis |
| title_sort | pediatric tuberculosis outcomes and factors associated with unfavorable treatment outcomes in botswana 2008 2019 a retrospective analysis |
| topic | Pediatric Tuberculosis Outcomes Associated factors Botswana |
| url | https://doi.org/10.1186/s12889-022-14477-y |
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