Childhood Tuberculosis and Treatment Outcome in Tertiary Referral Hospital in Malaysia

Background :Tuberculosis (TB) contributes a significant morbidity and mortality in children worldwide.

Objectives :The study objective was to described the characteristics and treatment outcomes of children with TB in Women and Children Hospital Kuala Lumpur (WCHKL).

Method :A retrospective cross -sectional study conducted in paediatric infectious diseases out-patient clinic using a newly formed TB registry. All children (below 18 years) diagnosed TB and follow-up from July 2019 to August 2020 are included. Demographic and clinical characteristic as well as treatment outcome were assessed.

Results :A total of 45 children were enrolled in this registry (median age: 5 years) and 11(24.4%) of them were excluded following diagnosis of latent TB infection. The diagnosis of TB disease was made based on either microbiologically proven or non-microbiologically proven in the presence of a clinical diagnosis of TB or suggestive radiographic findings. Out of 34 children, more than half were female (55.9%) with children below 5 years of age make up 44.1% (15/34). The distribution of TB types were as follows: pulmonary TB 23.5%, extrapulmonary TB 17.6% and disseminated TB 55.9%. Four children (11.9%) were immunocompromised and one of them had Wiskot-Aldrich syndrome . Only 2 children (5.8%) had drug induced liver injury .One child with disseminated disease had treatment interruption needing re-treatment. Median duration of clinic follow-up were 12 months and none defaulted. Twelve children (35.8%) had completed the treatment. No mortality from TB was recorded

Conclusion :TB in children when diagnosed early improve mortality and children below 5 years of age remains at risk. Follow-up during each phase of treatment is needed to look at compliant and drug related adverse events even when it is rare.