Journal article
Predictors of mortality in Ugandan children with TB, 2016-2021
The international journal of tuberculosis and lung disease, Vol.27(9), pp.668-674
09/01/2023
DOI: 10.5588/ijtld.22.0622
PMCID: PMC10443779
PMID: 37608479
Abstract
BACKGROUND: The burden of pediatric TB is high in Uganda. Our objective was to evaluate predictors of mortality during TB treatment among children at an urban and a rural referral hospital.METHODS: We designed a historical cohort study of TB cases at Mulago National
Referral Hospital, Kampala; and Fort Portal Regional Referral Hospital, Fort Portal, Uganda, in children aged <15 years from 2016 to 2021. We used Kaplan-Meier models to estimate survival and fit multivariable Cox regression models to determine mortality hazards during TB treatment.RESULTS:
We identified 1,658 children diagnosed with TB from 2016 to 2021. Of 1,623 children with known treatment outcomes, 127/1,623 (7.8%) died during TB treatment, 1,298/1,623 (78.3%) completed treatment, 150/1,623 (9.2%) were lost to follow-up, and two children failed treatment. Using Kaplan-Meier
functions, the median time to death was 27 days following treatment initiation. In adjusted Cox models, predictors of mortality included HIV (aHR 1.68, 95% CI 1.01-2.81), moderate malnutrition (aHR 2.22, 95% CI 1.18-4.16), and severe malnutrition (aHR 2.92, 95% CI 1.75-4.87).CONCLUSION:
Mortality was high at an urban and a rural referral hospital among children who initiated TB treatment from 2016 to 2021, with the majority of deaths occurring during the intensive phase of TB treatment. Malnutrition and HIV were significant predictors of death during treatment.
Details
- Title: Subtitle
- Predictors of mortality in Ugandan children with TB, 2016-2021
- Creators
- G. L. Becker - Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA, USAP. Amuge - Baylor College of Medicine Children’s FoundationR. Ssebunya - Baylor College of Medicine Children’s FoundationM. Motevalli - Baylor College of Medicine Children’s FoundationA. Adaku - Fort Portal HospitalM. Juma - Baylor College of Medicine Children’s FoundationE. Wobudeya - Mulago HospitalP. Elyanu - Baylor College of Medicine Children’s FoundationJ. B. Jackson - University of IowaA. Kekitiinwa - Baylor College of Medicine Children’s FoundationR. J. Blount - Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA, USA
- Resource Type
- Journal article
- Publication Details
- The international journal of tuberculosis and lung disease, Vol.27(9), pp.668-674
- Publisher
- International Union Against Tuberculosis and Lung Disease
- DOI
- 10.5588/ijtld.22.0622
- PMID
- 37608479
- PMCID
- PMC10443779
- ISSN
- 1027-3719
- eISSN
- 1815-7920
- Language
- English
- Date published
- 09/01/2023
- Academic Unit
- Pulmonary, Critical Care, and Occupational Medicine; Occupational and Environmental Health; Stead Family Department of Pediatrics; Pathology; Internal Medicine
- Record Identifier
- 9984455979602771
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