Evaluation of treatment outcomes and associated risk factors in children with TB in Bangladesh.

Abstract

Background: Children aged 0-14 years old make up 4% of the total number of people diagnosed with TB in Bangladesh. Local pediatric treatment outcomes and associated factors are poorly understood; further understanding can inform tailored interventions to close delivery gaps.

Methods: To assess the risk factors for unsuccessful treatment outcomes among children receiving TB treatment in 119 health facilities in Mymensingh Division, we conducted systematic verbal screening from 2018 to 2021. Unsuccessful outcomes, including death, treatment failure, or loss to follow-up (LTFU), were analysed using log-binomial regression to examine the association with demographic and clinical characteristics.

Results: Among 1,967 children with reported outcomes, 99.3% (n = 1,954) were successful. The primary reason for unsuccessful treatment was LTFU (n = 12, 0.6%), followed by treatment failure (n = 1, 0.1%). After controlling for age and sex, children with fever had a reduced risk of unsuccessful outcomes compared to those without fever (RR 0.23, 95% CI 0.06-0.82).

Conclusion: Most children with TB were successfully treated. LTFU was the leading reason for unsuccessful treatment outcomes in this cohort. Children with fever were less likely to have unsuccessful treatment outcomes, possibly because they were more intensely engaged in care than children without fever due to their presentation of symptoms. Continued research on pediatric TB presentation and treatment outcomes is essential for developing targeted strategies for early detection and treatment support.