IngentaConnect Reported childhood tuberculosis treatment outcomes, Gaborone and ...

Authors: Oeltmann, J.E.¹; Chengeta, B.²; Mboya, J.J.³; Wells, C.D.⁴; Kilmarx, P.H.⁵; Samandari, T.⁶; Nelson, L.J.⁴

Source: The International Journal of Tuberculosis and Lung Disease, Volume 12, Number 2, February 2008 , pp. 186-192(7)

Publisher: International Union Against Tuberculosis and Lung Disease

Abstract:

SETTING: Botswana.

OBJECTIVES: To estimate frequencies of tuberculosis (TB) treatment outcomes, assess the validity of reported treatment outcomes, and identify risk factors for death during TB treatment among children aged <15 years during 1998-2002.

DESIGN: We examined TB treatment outcome frequencies using the national Electronic TB Registry (ETR) data. Treatment and medical records were reviewed to calculate predictive values (PV) for outcomes recorded in the ETR. We interviewed parents of children treated for TB and assessed risk factors for death during treatment via case-control study.

RESULTS: Of 5483 patients, 3646 (67%) were cured or completed treatment and 577 (10.5%) died during treatment. The PV for ETR was 76% for death and 97% for cured or completed treatment. We interviewed parents of 91 children who died during treatment and 220 children who completed treatment. Human immunodeficiency virus (HIV) status was unknown for 76% of the children and 54% of the parents. Parent-reported adverse effects to anti-tuberculosis medication (adjusted odds ratio [aOR] 4.9, 95% confidence limit [CL] 2.2-9.2), and lower patient age (aOR 2.2, 95%CL 1.2-4.2) were associated with death during treatment.

CONCLUSIONS: TB control programs in Botswana should assess for potential adverse effects of anti-tuberculosis medication and expand HIV testing among children with TB and their parents.

Keywords: childhood tuberculosis; treatment outcomes; Africa

Document Type: Regular paper

Affiliations: 1: Division of TB Elimination, Centers for Disease Control and Prevention, Atlanta, Georgia, USA; Epidemic Intelligence Service, Office of Career and Workforce Development, Centers for Disease Control and Prevention, Atlanta, Georgia, USA 2: BOTUSA Project, Gaborone, Botswana 3: Botswana National Tuberculosis Programme, Ministry of Health, Gaborone, Botswana 4: Division of TB Elimination, Centers for Disease Control and Prevention, Atlanta, Georgia, USA 5: BOTUSA Project, Gaborone, Botswana; and Global AIDS Program, Centers for Disease Control and Prevention, Atlanta, Georgia, USA 6: Division of TB Elimination, Centers for Disease Control and Prevention, Atlanta, Georgia, USA; and BOTUSA Project, Gaborone, Botswana

Reported childhood tuberculosis treatment outcomes, Gaborone and Francistown, Botswana, 1998-2002