Correlates of tuberculosis in children under the age of 15 years

TL;DR

This study found that 9.4% of hospitalized children under 15 in Zambia had active TB, with HIV and malnutrition being major risk factors.

Contribution

The study provides new insights into TB prevalence and risk factors among children in Zambia, a gap in existing literature.

Findings

The prevalence of active TB in hospitalized children under 15 was 9.4%.

Children living with HIV had 6.3 times higher odds of active TB.

Malnourished children had 10.4 times higher odds of active TB.

Abstract

Tuberculosis (TB) remains a significant public health challenge, particularly among vulnerable populations like children. This is especially true in Sub-Saharan Africa, where the burden of TB in children is substantial. Zambia ranks 21st among the top 30 high TB endemic countries globally. While studies have explored TB in adults in Zambia, the prevalence and associated factors in children are not well documented. This study aimed to determine the prevalence and sociodemographic, and clinical factors associated with active TB disease in hospitalized children under the age of 15 years at Livingstone University Teaching Hospital (LUTH), the largest referral center in Zambia’s Southern Province.

This retrospective cross-sectional study of 700 pediatric patients under 15 years old, utilized programmatic data from the Pediatrics Department at LUTH. A systematic sampling method was used to select participants from medical records. Data on demographics, medical conditions, anthropometric measurements, and blood tests were collected. Data analysis included descriptive statistics, chi-square tests, and multivariable logistic regression to identify factors associated with TB.

The median age was 24 months (interquartile range (IQR): 11, 60) and majority were male (56.7%, n = 397/700). Most participants were from urban areas (59.9%, n = 419/700), and 9.2% (n = 62/675) were living with HIV. Malnutrition and comorbidities were present in a significant portion of the participants (19.0% and 25.1%, respectively). The prevalence of active TB cases was 9.4% (n = 66/700) among hospitalized children. Persons living with HIV (Adjusted odds ratio (AOR) of 6.30; 95% confidence interval (CI) of 2.85, 13.89, p< 0.001), and those who were malnourished (AOR: 10.38, 95% CI: 4.78, 22.55, p< 0.001) had a significantly higher likelihood of developing active TB disease.

This study revealed a prevalence 9.4% active TB among hospitalized children under 15 years at LUTH. HIV status and malnutrition emerged as significant factors associated with active TB disease. These findings emphasize the need for pediatric TB control strategies that prioritize addressing associated factors to effectively reduce the burden of tuberculosis in Zambian children.

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