Childhood TB in China: notification, characteristics and risk factors for outcomes, 2010–2017
OBJECTIVE: To describe the epidemiology of childhood (age < 15 years) TB, including treatment outcomes and risk factors for unfavourable outcomes and death.
DESIGN: We used a cross-sectional design for the descriptive component and a cohort design for treatment outcomes and their risk factors (assessed using log binomial regression).
RESULTS: Of 40 561 children, 77.7% (n = 31 529) were aged 10–14 years and 19.6% (n = 7931) were bacteriologically confirmed. Around 14% (n = 5827) belonged to migrant families (internal migration) and 4.0% (n = 1,642) were actively detected. Over 8 years, annual notification was consistently very low (<1%), and notification of bacteriologically confirmed TB decreased by half. Unfavourable outcomes were seen in 6% and deaths in 0.4%; there were no significant changes over the years. The independent predictors of unfavourable outcomes were active case finding and extrapulmonary TB. Children belonging to migrant family were more likely to die. Independent predictors of unfavourable outcomes as well as death were age < 5 years and previous treatment.
CONCLUSION: China needs to address the issue of under-detection of childhood TB, especially in younger age groups. The risk factors identified require attention if China is to attain zero child TB deaths.
Keywords: children with TB; epidemiological characteristics; mortality; notification; treatment outcomes; trends
Document Type: Research Article
Affiliations: 1: National Center for Tuberculosis Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 2: Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing 3: Zhejiang Center for Tuberculosis Control and Prevention, Hangzhou, China 4: International Union Against Tuberculosis and Lung Disease (The Union), Paris, France, The Union South-East Asian Office, New Delhi, India
Publication date: December 1, 2020
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