Childhood tuberculosis in Malawi: nationwide case-finding and treatment outcomes

Harries, A. D., Hargreaves, N.J., Graham, S. M., Mwansambo, C., Kazembe, P., Broadhead, R. L., Maher, D. and Salaniponi, F. M. (2002) 'Childhood tuberculosis in Malawi: nationwide case-finding and treatment outcomes'. International Journal of Tuberculosis and Lung Disease, Vol 6, Issue 5, pp. 424-431.

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Abstract

SETTING: All 43 non-private hospitals (three central, 21 district and 19 mission) in Malawi that register and treat adult and paediatric TB cases. OBJECTIVE: To assess the rate, pattern and treatment outcome of childhood TB case notifications in Malawi in 1998. DESIGN: Retrospective data collection using TB registers, treatment cards and information from health centre registers. Information was collected on number of cases, types of TB and treatment outcomes using standardised definitions. RESULTS: There were 22982 cases of TB registered in Malawi in 1998, of whom 2739 (11.9%) were children. Children accounted for 1.3% of all case notifications with smear-positive pulmonary TB (PTB), 21.3% with smear-negative PTB and 15.9% with extra-pulmonary TB (EPTB). Estimated rates of TB in children were 78/100 000 in those aged less than one year, 83/100 000 in those aged 1-4 years and 33/100 000 in those aged 5-14 years. A significantly higher proportion of TB cases was diagnosed in central hospitals. Only 45% of children completed treatment. There were high rates of death (17%), default (13%) and unknown treatment outcomes (21%). Treatment outcomes were worse in younger children and in children with smear-negative PTB. Treatment completion was best (76%) and death rates lowest (11%) for the 127 children with smear-positive PTB. CONCLUSION: Childhood TB is common in Malawi and treatment outcomes are poor. Research should be directed towards improved diagnosis and follow-up of children with TB, and the National TB Programme should support appropriate management of childhood contacts of smear positive PTB cases.

Item Type:	Article
Subjects:	WA Public Health > WA 30 Socioeconomic factors in public health (General) WA Public Health > Health Problems of Special Population Groups > WA 395 Health in developing countries WF Respiratory System > Tuberculosis > WF 415 Tuberculosis in childhood WS Pediatrics > Diseases of Children and Adolescents > By System > WS 280 Respiratory system
Faculty: Department:	Groups (2002 - 2012) > Child & Reproductive Health Group
Depositing User:	Lynn Roberts-Maloney
Date Deposited:	28 Jun 2013 11:01
Last Modified:	06 Feb 2018 13:05
URI:	https://archive.lstmed.ac.uk/id/eprint/2932

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