Locations of tuberculosis in children hospitalized at the Bangui Pediatric University Hospital Complex (Central African Republic).

Abstract

Introduction: Extrapulmonary tuberculosis (TB) in children poses a significant public health challenge due to its high prevalence, severe forms, diagnostic difficulties, and impact on pediatric morbidity and mortality. The primary objective of this study was to characterize extrapulmonary tuberculosis in children at the Bangui Pediatric University Hospital Complex (CHUPB).

Materials and methods: We conducted a retrospective descriptive study from January 1, 2022, to April 30, 2024. We included children aged 1 month to 15 years who were hospitalized at the CHUPB and had a confirmed diagnosis of extrapulmonary tuberculosis in their medical records. The data were entered into Microsoft Excel 2016 and analyzed using R Studio.

Results: The hospitalization rate was 1.57% (287 out of 18,257 hospitalized children). Only 280 complete medical records were analyzed for the study. The mean age was 8.2 ± 3.1 years, with a sex ratio of 1.45. Prolonged fever was the primary reason for seeking medical care (97.5%), and the average delay in seeking care was one month and six days. Low socioeconomic status was observed in 68.5% of the children, and incomplete BCG vaccination status was observed in 86.7% of them. Tuberculosis was present in 29% of cases, and HIV infection was present in 23.1% of them. Tuberculosis was unifocal in 53.9% of cases and multifocal in 46.1%. Neuromeningeal involvement accounted for 30.5% of cases, while lymph node and peritoneal involvement accounted for 38.5%. The smear positivity rate for AFB was 66.9% and that of the GeneXpert test was 33.3%, with a rifampicin resistance rate of 12.1%. Antituberculosis treatment was administered to 98.6% of the children. The case fatality rate was 10.3%, and the mean length of hospitalization was 12 days.

Conclusion: Extrapulmonary tuberculosis remains common and severe among children at the CHUPB, with diagnostic delays, low vaccination coverage, and high mortality rates. In order to reduce morbidity and make progress toward Sustainable Development Goal 3, it is crucial to strengthen screening and vaccination efforts, improve access to care, and raise awareness among families and healthcare workers.