Paediatric tuberculosis treatment outcomes and associated factors in health facilities of Shashemene Town, Southern Ethiopia: A retrospective analysis

Background: Tuberculosis treatment outcomes serve as a proxy indicator of the quality of tuberculosis treatment. In Ethiopia, little is known about the epidemiology, prevalence and treatment outcomes of paediatric tuberculosis. This study aimed to assess paediatric tuberculosis treatment outcomes and associated factors in health facilities of Shashemene town, Southern Ethiopia. Methods : A cross-sectional study design was used to review a six-years retrospective data from February to March 2019 at Shashemene town, Southern Ethiopia. Using a simple random sampling method, 390 registered paediatric patients with tuberculosis who had known treatment outcomes were selected from the unit TB register logbook. Data were entered into Epi Info version 7 and analyzed using SPSS version 23. Bivariable and multivariable logistic regression analysis were used to estimate the odds of paediatric tuberculosis treatment outcomes in Shashemene Town, Ethiopia. Significant variables at p-value < 0.25 in the bivariable analysis were entered into the multivariable logistic regression analysis. A p-value of < 0.05 was considered a statistically significant association between the predictor variables and poor treatment success outcomes. Results : Data of 390 paediatric TB cases were extracted from the unit TB register logbook and analyzed. The cases were slightly more common among females (51.5%) than males (48.5%). Of these, 95.6% were new cases and 36.7% were under 5 years old. More than half 213(54.6%) of the participants had pulmonary smear-negative TB. Extra pulmonary TB and pulmonary smear-positive TB accounted for 140(35.9%) and 37(9.5%) cases respectively. The overall paediatric tuberculosis treatment success was 356(91.3%). Among 390 patients, 25(6.4%) were cured, 331(84.9%) completed treatment, 14(3.6%) lost to follow-up, 17(4.4%) died and 3(0.7%) experienced treatment failure. Age 5-9 years (AOR = 0.362, 95% CI [0.138-0.950]), 10-14 years (AOR =0.354, 95% CI [0.130-0.963]), lost to follow-up category of TB (AOR=8.166, 95% CI [1.437-46.410]), HIV-positive status (AOR =5.822, 95% CI [2.009-16.869]) and rural residence (AOR= 2.39, 95% CI [1.002-5.702] were independently associated with treatment outcomes. Conclusions : The overall treatment success rate in this study was high. This success rate meets the WHO target of 90% and the End TB strategy. Poor paediatric TB treatment outcomes such as death, lost to follow-up and treatment failure remain a public health concern in Ethiopia and these were significantly influenced by younger age, rural residence, previous history of lost to follow up and HIV-TB coinfection. Close follow-up during treatment, collaboration between the TB and HIV programs and expansion of the DOTS service are essential to decrease poor paediatric TB treatment outcomes.