Abstract
BackgroundTuberculosis (TB) among children remains a significant public health problem in many parts of the world. The objective of this study was to describe the characteristics of TB patients and to determine the predictors of treatment success among children in Malaysia.MethodsSecondary data from MyTB version 2.1, a national database, were analysed using R version 3.6.1. Descriptive analysis and multivariable logistic regression were conducted to identify treatment success and its determinants.ResultsIn total, 3630 cases of TB cases were registered among children in Malaysia between 2013 and 2017. The overall treatment success rate was 87.1% in 2013 and plateaued between 90.1 and 91.4% from 2014 to 2017. TB treatment success was positively associated with being a Malaysian citizen (aOR = 3.43; 95% CI = 2.47, 4.75), being a child with BCG scars (aOR = 1.93; 95% CI = 1.39, 2.68), and being in the older age group (aOR = 1.06; 95% CI = 1.03, 1.09). Having HIV co-infection (aOR = 0.31; 95% CI = 0.16, 0.63), undergoing treatment in public hospitals (aOR = 0.38; 95% CI =0.25, 0.58), having chest X-ray findings of advanced lesion (aOR = 0.48; 95% CI = 0.33, 0.69), having EPTB (aOR = 0.58; 95% CI = 0.41, 0.82) and having sputum-positive PTB (aOR = 0.58; 95% CI = 0.43, 0.79) were negatively associated with TB treatment success among children.ConclusionsThe overall success rate of treatment among children with TB in Malaysia has achieved the target of 90% since 2014 and remained plateaued until 2017. The socio-demographic characteristics of children, place of treatment, and TB disease profile were associated with the likelihood of TB treatment success among children. The treatment success rate can be increased by strengthening contact tracing activities and promoting early identification targeting the youngest children and non-Malaysian children.
Highlights
Tuberculosis (TB) among children remains a significant public health problem in many parts of the world
TB treatment success was positively associated with being a Malaysian citizen, have Bacillus Calmette–Guérin (BCG) scars, and being in the older age group
This study describes the characteristics of children with TB in Malaysia from 2013 to 2017 using the recommended national TB control programme (NTP) surveillance database
Summary
Tuberculosis (TB) among children remains a significant public health problem in many parts of the world. The objective of this study was to describe the characteristics of TB patients and to determine the predictors of treatment success among children in Malaysia. Tuberculosis (TB) disease affects children aged 0 to 14 years due to recent Mycobacterium tuberculosis (mtb) infection [1, 2]. TB among children reflects the ongoing TB trasmission in the community, which needs public health attention [3]. Children with TB accounted for 11% of the total TB cases in 2018 [4]. In Malaysia, children had approximately 3% of the total TB cases for the 2010–2015 Malaysian cohort [5]. Countries neighbouring Malaysia, such as the Philippines, Indonesia, Myanmar and Thailand, are among the countries with a high TB burden [4]
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