Magnitude of Tuberculosis in Children Aged Under 18 Years at Amana Regional Hospital in Dar es Salaam from 2022 and 2024

Sonia Nada Edward Sokoine ( Department of Community Medicine,Kairuki University, , P.O. Box 65300, Dar es Salaam, Tanzania )

Dimple Prakash Sonigra ( Department of Community Medicine,Kairuki University, , P.O. Box 65300, Dar es Salaam, Tanzania )

Julieth Elizeus Nyamiti ( Department of Obstetrics  and Gynaecology ,Kairuki University, , P.O. Box 65300, Dar es Salaam, Tanzania )

https://doi.org/10.37155/3060-8708-0203-3

简介

Background: Tuberculosis (TB) remains a significant public health challenge among children, particularly in resource-limited settings like Sub-Saharan Africa. Despite global efforts to reduce its burden, childhood TB is often under-diagnosed and under treated, especially in regions with high HIV prevalence.

Objective: This study aimed to determine the prevalence and associated factors of TB among children under 18 years at Amana Regional Hospital in Dar es Salaam, Tanzania, from 2022 to 2024.

Design and Setting: A retrospective cross-sectional study was conducted, analyzing medical records of children diagnosed with TB at Amana Regional Hospital between 2022 and 2024. Data on socio-demographic characteristics, symptoms, diagnostic methods, HIV status, and treatment initiation were extracted from TB clinic registries and analyzed using descriptive statistics in SPSS version 26.0.

Participants: A total of 382 children were included in the study. Of these, 57.6% were male and 42.4% female. The majority were aged 2–5 years (31.1%) and resided in urban areas (57.6%). Inclusion criteria were children under 18 years with confirmed TB diagnosis through microscopy or Gene-Xpert, while exclusion criteria included children without documented confirmation or incomplete records.

Primary and Secondary Outcome Measures: Primary outcome measure: prevalence of confirmed TB among children under 18 years during the study period. Secondary outcome measures: socio-demographic distribution of TB cases, presenting symptoms, diagnostic methods used, HIV co-infection rates, and proportion of children initiating TB and ARV treatment.

Results: Of the 382 children studied, 68.3% (n=261) were diagnosed with TB, with a higher prevalence among males (57.6%) and the 2-5-year age group (31.1%). Urban residence was predominant (57.6%), and common symptoms included persistent cough (65.7%) and fever (52.1%). Microscopy (52.6%) and Gene-Xpert (39.0%) were the primary diagnostic tools [5]. HIV co-infection was observed in 20.7% of cases, with 65.5% of TB-positive children initiating treatment [26].

Conclusion: The high burden of TB among children at Amana Regional Hospital underscores the need for improved diagnostic capacity, early intervention, and integrated TB-HIV services to reduce morbidity and mortality in this vulnerable population.

关键字

Tuberculosis; Tanzania; HIV; Pediatrics; Sub saharan Africa

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参考文献

[1].WHO. Tuberculosis (TB) [Internet]. www.who.int. 2023. Available from:https://www.who.int/news-room/fact-sheets/detail/tuberculosis#:~:text=Tuberculosis%20(TB)%20is%20an%20infectious
[2].Bloom BR, Atun R, Cohen T, Dye C, Fraser H, Gomez GB, et al. Tuberculosis. In: Disease Control Priorities, Third Edition (Volume 6): Major Infectious Diseases. The World Bank; 2017. p. 233–313.
[3].Tuberculosis (TB) [Internet]. WHO | Regional Office for Africa. Available from: https://www.afro.who.int/health-topics/tuberculosis-tb
[4].Aketi L, Kashongwe Z, Kinsiona C, Fueza SB, Kokolomami J, Bolie G, et al. Childhood tuberculosis in a sub-Saharan tertiary facility: Epidemiology and factors associated with treatment outcome. PLoS One [Internet]. 2016;11(4):e0153914. Available from: https://pubmed.ncbi.nlm.nih.gov/27101146/
[5].Reid MJA, Saito S, Fayorsey R, Carter RJ, Abrams EJ. Assessing capacity for diagnosing tuberculosis in children in sub-Saharan African HIV care settings [Short communication]. Int J Tuberc Lung Dis [Internet]. 2012;16(7):924–7. Available from: https://pubmed.ncbi.nlm.nih.gov/22583761/
[6].Seid G, Alemu A, Dagne B, Sinshaw W, Gumi B. Tuberculosis in household contacts of tuberculosis patients in sub-Saharan African countries: A systematic review and meta-analysis. J Clin Tuberc Other Mycobact Dis [Internet]. 2022;29(100337):100337. Available from: https://pubmed.ncbi.nlm.nih.gov/36425906/
[7].Uwishema O, Rai A, Nicholas A, Abbass M, Uweis L, Arab S, et al. Childhood tuberculosis outbreak in Africa: is it a matter of concern? Int J Surg [Internet]. 2023;109(5):1539–42. Available from: http://dx.doi.org/10.1097/js9.0000000000000140
[8].Isaac WE, Jalo I, Yohanna G, Rasaki A, Ebisike K, Girbo A, et al. Case fatality rate of childhood Tuberculosis: Experience from federal teaching hospital Gombe: A two decade review. West Afr J Med [Internet]. 2023;40(11 Suppl 1). Available from: https://pubmed.ncbi.nlm.nih.gov/37970780/
[9].Adejumo OA, Daniel OJ, Adebayo BI, Adejumo EN, Jaiyesimi EO, Akang G, et al. Treatment outcomes of childhood TB in Lagos, Nigeria. J Trop Pediatr [Internet]. 2016;62(2):131–8. Available from: https://pubmed.ncbi.nlm.nih.gov/26705331/
[10].US Department of Health and Human Services. Tuberculosis. National Institute of Allergy and Infectious Diseases; n.d. Accessed 3 September 2022.
[11].Gessner BD, Weiss NS, Nolan CM. Risk factors for pediatric tuberculosis infection and disease after household exposure to adult index cases in Alaska. J Pediatr [Internet]. 1998;132(3):509–13. Available from: https://pubmed.ncbi.nlm.nih.gov/9544910/
[12].Stival A, Chiappini E, Montagnani C, Orlandini E, Buzzoni C, Galli L, de Martino M. Sexual dimorphism in tuberculosis incidence: children cases compared to adult cases in Tuscany from 1997 to 2011. PLoS ONE. 2014;9(9):e105277. doi: 10.1371/journal.pone.0105277
[13].Jaganath D, Zalwango S, Okware B, Nsereko M, Kisingo H, Malone L, Lancioni C, Okwera A, Joloba M, Mayanja-Kizza H, Boom WH. Contact investigation for active tuberculosis among child contacts in Uganda. Clin Infect Dis. 2013;57(12):1685–1692. doi: 10.1093/cid/cit645.
[14].Laghari M, Sulaiman SA, Khan AH, Talpur BA, Bhatti Z, Memon N. Contact screening and risk factors for TB among the household contact of children with active TB: a way to find source cases and new TB cases. BMC Public Health. 2019;19(1):1–10. doi: 10.1186/s12889-019-7597-0.
[15].Chawla K, Burugina Nagaraja S, Siddalingaiah N, Sanju C, Shenoy VP, Kumar U, Das A, Hazra D, Shastri S, Singarajipur A, Reddy RC. Challenges perceived by health care providers for implementation of contact screening and isoniazid chemoprophylaxis in Karnataka, India. Tropical Medicine and Infectious Disease. 2021;6(3):167. doi: 10.3390/tropicalmed6030167
[16].Karim MR, Rahman MA, Mamun SA, Alam MA, Akhter S. Risk factors of childhood tuberculosis: a case control study from rural Bangladesh. WHO South-East Asia journal of public health. 2012;1(1):76–84. doi: 10.4103/2224-3151.206917
[17].Nyasulu P, Kambale S, Chirwa T, Umanah T, Singini I, Sikwese S, Banda HT, Banda RP, Chimbali H, Ngwira B, Munthali A. Knowledge and perception about tuberculosis among children attending primary school in Ntcheu District. Malawi Journal of Multidisciplinary Healthcare. 2016;9:121. doi: 10.2147/JMDH.S97409
[18].Tornee S, Kaewkungwal J, Fungladda W, Silachamroon U, Akarasewi P, Sunakorn P. The association between environmental factors and tuberculosis infection among household contacts. Southeast Asian J Trop Med Public Health. 2005;36:221–224
[19].Siddalingaiah N, Chawla K, Nagaraja SB, Hazra D. Risk factors for the development of tuberculosis among the pediatric population: a systematic review and meta-analysis. Eur J Pediatr [Internet]. 2023;182(7):3007–19. Available from: http://dx.doi.org/10.1007/s00431-023-04988-0
[20].Dodd PJ, Prendergast AJ, Beecroft C, Kampmann B, Seddon J. The impact of HIV and antiretroviral therapy on TB risk in children: a systematic review and meta-analysis. Thorax. 2017;72(6):559–575. doi: 10.1136/thoraxjnl-2016-209421.
[21].den Boon S, Verver S, Marais BJ, Enarson DA, Lombard CJ, Bateman ED, Irusen E, Jithoo A, Gie RP, Borgdorff MW, Beyers N. Association between passive smoking and infection with Mycobacterium tuberculosis in children. Pediatrics. 2007;119(4):734–739. doi: 10.1542/peds.2006-1796
[22].Patra J, Bhatia M, Suraweera W, Morris SK, Patra C, Gupta PC, Jha P. Exposure to second-hand smoke and the risk of tuberculosis in children and adults: a systematic review and meta-analysis of 18 observational studies. PLoS Med. 2015;12(6):e1001835. doi: 10.1371/journal.pmed.1001835
[23].Shrestha S, Bichha RP, Sharma A, Upadhyay S, Rijal P. Clinical profile of tuberculosis in children. Nepal Medical College journal : NMCJ [Internet]. 2011;13(2). Available from: https://pubmed.ncbi.nlm.nih.gov/22364096/
[24].Sass P. Tuberculosis infection and disease in children. Am Fam Physician [Internet]. 1996;53(6). Available from: https://pubmed.ncbi.nlm.nih.gov/8623721/
[25].Cruz AT, Starke JR. Clinical manifestations of tuberculosis in children. Paediatr Respir Rev [Internet]. 2007;8(2):107–17. Available from: https://pubmed.ncbi.nlm.nih.gov/17574154/
[26].Njau JC, Aboud S. Tuberculosis in Hiv-Infected Tanzanian children below 14 years. East Afr J Public Health [Internet]. 2011;7(3). Available from: https://pubmed.ncbi.nlm.nih.gov/21516954/
[27].PrayGod G, Todd J, McDermid JM. Early childhood tuberculosis in northwestern Tanzania. Int J Tuberc Lung Dis [Internet]. 2012;16(11):1455–60. Available from: https://pubmed.ncbi.nlm.nih.gov/23006814/
[28].Thomas TA. Tuberculosis in children. Pediatr Clin North Am [Internet]. 2017;64(4):893–909. Available from: http://dx.doi.org/10.1016/j.pcl.2017.03.010

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