Outcomes of childhood TB in countries with a universal BCG vaccination policy

Author:

Dias J.V.1,Varandas L.2,Gonçalves L.3,Kagina B.4

Affiliation:

1. Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Lisbon, Department of Paediatrics, Hospital Beatriz Ângelo, Loures,

2. Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Lisbon, NOVA Medical School, Universidade Nova de Lisboa, Lisbon, Department of Paediatrics, Hospital Dona Estefânia, Lisbon,

3. Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Lisbon, Centro de Estatística e Aplicações da Universidade de Lisboa, Lisbon, z-Stat4life, Lisbon, Portugal;

4. Vaccines for Africa Initiative, School of Public Health, University of Cape Town, Cape Town, Institute of Molecular Medicine & Infectious Diseases, University of Cape Town, South Africa

Abstract

<sec id="st1"><title>BACKGROUND</title>TB remains an important cause of childhood morbidity and mortality. Underdiagnosis, underreporting and limited data on the outcomes of childhood TB have led to an underestimation of its impact.</sec><sec id="st2"><title>METHODS</title>This was a systematic review to characterise childhood TB outcomes. Studies reporting relevant epidemiological data on children between 0 and 14 years of age, with a particular focus on treatment outcomes, from countries with universal bacilli Calmette-Guérin (BCG) vaccination and conducted between 2000 and 2020 were selected. Random effects meta-analysis was performed in R software.</sec><sec id="st3"><title>RESULTS</title>We identified 1,806 references and included 35 articles. Among children with TB, the overall proportion of unfavourable outcomes was 19.5% (95% CI 14.4–25.8) and pooled case-fatality ratio was 6.1% (95% CI 4.3–8.4). The proportion of deaths observed among children between 0 and 4 years old was 6.6% (95% CI 4.9–8.7) and 4.6% (95% CI 3.1–6.9) in older children. TB and HIV co-infected children presented a case-fatality ratio of 15.1% (95% CI 7.9–27.0).</sec><sec id="st4"><title>CONCLUSIONS</title>Despite the efforts made in the last decades, treatment outcomes in childhood TB are still worrisome. Efforts to fill existing gaps and design health policies targeting vulnerable populations, such as children, should be intensified to tackle the global TB burden.</sec>

Publisher

International Union Against Tuberculosis and Lung Disease

Cited by 1 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

1. Pediatric TB treatment outcomes: targets for improvement;The International Journal of Tuberculosis and Lung Disease;2024-06-01

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