Childhood Tuberculosis: Evaluation Of Clinical Outcomes And Treatment Compliance In Multicenter Hospitals Of Sindh, Pakistan

• Main Author: Laghari, Madeeha
• Format: Thesis
• Language: English
• Published: 2018
• Subjects: RC306-320.5 Tuberculosis
• Online Access: http://eprints.usm.my/48552/1/MADEEHA%20LAGHARI_hj.pdf; http://eprints.usm.my/48552/
• Institution: Universiti Sains Malaysia

Pakistan is ranked 11 among the high tuberculosis (TB) burden countries where TB is rated 6th of top 10 causes of mortality. Although, the national guidelines for the diagnosis and management of TB in children were established in 2007, but little is known about the management and treatment outcomes of childhood TB in Pakistan. For this purpose, children treated under Directly Observed Treatment Short course (DOTS) at (5) multicentre hospitals of Sindh were recruited as cohort in this observational study. Total 2,167 children were registered during retrospective phase from 2011 to 2015 and for prospective phase from 1st June 2016 to 30th November 2016, 508 children were enrolled with TB at the study site. During the study period, childhood TB accounted 12.2% of all TB cases in Hyderabad, Jamshoro and Matiari districts. In the present study, 12.1% were bacteriologically confirmed sputum smear positive cases. At the end of intensive phase, 79.3% of patients achieved sputum smear conversion. Patients who had household contacts with TB and experienced adverse effects were significantly less likely to achieve sputum conversion and were more likely to become sputum positive during the treatment. Around 13.2% of patients came across with adverse effects. In multivariate analysis females and children with previous treatment were at greater risk to develop adverse effects due to anti-TB drugs. The overall treatment success rate was recorded as 93%. Rural residents, sputum smear positive, children with previous treatment, those who had ADRs and household contacts with TB emerged as predictors for unsuccessful treatment outcomes.