Department of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, 11800, Minden Penang, Malaysia.
College of Pharmacy, Liaquat University of Medical and Health Sciences, Jamshoro, 76090, Pakistan.
BMC Infect Dis. 2019 Jan 24;19(1):82. doi: 10.1186/s12879-019-3702-3.
Understanding the explanations behind unsuccessful treatment outcomes in tuberculosis (TB) patients is important to improve treatment success. Treatment completion for TB is the mainstay of TB prevention and control. The study was aimed to assess the treatment outcomes and predictors for unsuccessful outcomes among children with TB.
This was a prospective multicenter study conducted in Sindh. Children aged ≤14 years enrolled from June to November 2016 were included. A structured data collection tool was used to gather information with respect to patients' socio-demographic, clinical and microbiological data. Additionally, to collect the information related to socio-economic and education level of caregivers, validated questionnaire was administered to the caregivers. Treatment outcomes were assessed according to the World Health Organization (WHO) guidelines. The relationship of unsuccessful treatment outcome with socio-demographic and clinical attributes of TB patients was analyzed using logistic regression model.
Childhood TB represented 19.3% (508/2634) of all TB cases in selected hospitals. Of these, 268/508 (52.8%) were females and one third of the children were aged ≤2 years (34.3%). In multivariate analysis, pulmonary smear positive TB (PTB+) (AOR = 5.910, 95%CI = 1.64-21.29), those with adverse drug reactions (AOR = 11.601, 95%CI = 4.06-33.12) and those who had known TB contacts (AOR = 3.128, 95%CI = 1.21-8.06) showed statistically significant association with unsuccessful treatment outcomes.
The high proportion of childhood TB cases (19.3%) demonstrates the continuation of TB transmission in the study setting. Furthermore, an increased focus on PTB+ patients, those with adverse drug reactions and household contact with TB is warranted.
了解结核病（TB）患者治疗失败的原因对于提高治疗成功率非常重要。完成结核病治疗是结核病防控的主要手段。本研究旨在评估儿童结核病患者的治疗结局和不良结局的预测因素。
这是在信德省进行的一项前瞻性多中心研究。2016 年 6 月至 11 月期间，纳入了年龄≤14 岁的患儿。使用结构化数据收集工具收集了患者的社会人口学、临床和微生物学数据。此外，为了收集与照顾者社会经济和教育水平相关的信息，对照顾者进行了验证问卷。根据世界卫生组织（WHO）的指南评估治疗结果。使用逻辑回归模型分析了治疗失败与结核病患者的社会人口学和临床特征之间的关系。
选定医院的所有结核病病例中，儿童结核病占 19.3%（508/2634）。其中，268/508（52.8%）为女性，三分之一的儿童年龄≤2 岁（34.3%）。多变量分析显示，肺部涂片阳性结核病（PTB+）（AOR=5.910，95%CI=1.64-21.29）、药物不良反应（AOR=11.601，95%CI=4.06-33.12）和已知的结核病接触者（AOR=3.128，95%CI=1.21-8.06）与治疗失败结果呈统计学显著关联。
儿童结核病病例比例较高（19.3%）表明研究环境中结核病仍在传播。此外，需要更加关注 PTB+患者、药物不良反应患者和有结核病家庭接触者。
