Historical neglect of pediatric tuberculosis (TB) compounding the absence of a universally effective vaccine highlights the importance of successful treatment in combating the global epidemic. Furthermore, compliance with international standards of pediatric TB treatment remains unknown in many high-burden, resource-limited settings.
In this cross-sectional study, using TB surveillance data, we assessed the treatment outcomes among 853 pediatric TB cases (< 15 years old), a study sample that represented all the pediatric TB cases with treatment outcome records in Harare, Zimbabwe, during 2013 – 2017. We also identified factors associated with treatment outcome by multivariate logistic regression.
Of these 853 analyzed cases, 57% were either cured or completed treatment. In a model accounting for confounding variables, hospital center and pretreatment sputum smear were associated with unfavorable treatment outcome. Cases from Beatrice Road Infectious Disease Hospital were 4 times as likely to have an unfavorable outcome compared to those from Wilkins Infectious Disease Hospital (adjusted odds ration [aOR]: 4.0; 95% CI 2.9 to 5.5). Children whose pretreatment sputum smear was positive were 2.4 times as likely to have an unfavorable outcome as those who were negative (aOR: 2.4; 95% CI 1.7 to 3.6).
Pediatric TB case management needs to be improved, especially among those with positive pretreatment sputum smear. Efforts to address TB treatment outcome disparities between clinical settings in high-burden settings, such as Harare, Zimbabwe, are essential in improving global TB control.
Copyright © 2020. Published by Elsevier Ltd.