A Retrospective Assessment of Treatment Outcomes and Predictors of Mortality in Inpatient Childhood Tuberculosis

International Journal of Medicine and Medical Sciences | Vol. 15, No. 1, January 2025 | pp. 1–8

DOI: 10.46882/2025/IJMMS/150001

Original Research Article

A Retrospective Assessment of Treatment Outcomes and Predictors of Mortality in Inpatient Childhood Tuberculosis

Evelyn N. Kamau¹, Tunde O. Adebayo², Sarah M. Touré¹*

¹Department of Paediatrics and Child Health, School of Medicine, University of Nairobi, Nairobi, Kenya.

²Department of Community Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria.

Abstract:

Pediatric tuberculosis (TB) presents notable diagnostic and therapeutic challenges, resulting in high mortality among hospitalized children in endemic regions. This retrospective institutional cohort study evaluated clinical treatment outcomes and specific predictors of mortality among children admitted with confirmed or highly probable pulmonary or extrapulmonary TB over a five-year period (2020–2024). De-identified medical files of 320 children aged 0 to 14 years were extracted and analyzed. Clinical outcomes were classified according to World Health Organization (WHO) definitions. Over the five-year study duration, successful treatment (cure or completion) was achieved in 74.4% (238/320) of the cases, the default rate was 8.1%, and the inpatient mortality rate was 14.4% (46/320). Extrapulmonary TB—primarily tuberculous meningitis and miliary TB—was identified in 38.8% of the cohort. The primary direct clinical cause of inpatient death was advanced respiratory failure complicated by severe malnutrition. Cox proportional hazards regression modeling demonstrated that an age under 2 years (HR = 2.9, 95% CI = 1.4–5.8, p < 0.01), concurrent severe acute malnutrition (HR = 3.4, 95% CI = 1.8–6.5, p < 0.001), and HIV co-infection without antiretroviral therapy (HR = 2.4, p < 0.05) were independent predictors of inpatient mortality. Mortality among children hospitalized with TB remains elevated, driven primarily by late clinical presentation and diagnostic delays. Improving outcomes requires the integration of sensitive molecular diagnostic tools, active contact tracing, and aggressive nutritional support systems.

Keywords: Pediatric Tuberculosis, Inpatient Mortality, Tuberculous Meningitis, Severe Acute Malnutrition, HIV Co-infection, Treatment Outcomes

Manuscript Timeline: Received: October 05, 2024; Revised: November 11, 2024; Accepted: December 04, 2024; Published: January 15, 2025.

Citation: Kamau EN, Adebayo TO, Touré SM. A Retrospective Assessment of Treatment Outcomes and Predictors of Mortality in Inpatient Childhood Tuberculosis. International Journal of Medicine and Medical Sciences, 2025, 15(1): 1–8. DOI: 10.46882/2025/IJMMS/150001

Subscribe to read the full article: https://internationalscholarsjournals.org/subscribe-to-read