Nationwide analysis of treatment outcomes in children and adolescents routinely treated for tuberculosis in The NetherlandsGafar, F., Van't Boveneind-Vrubleuskaya, N., Akkerman, O. W., Wilffert, B. & Alffenaar, J-W. C., 2020, In : European Respiratory Journal. 54, 4, 12 p., 1901402.
Research output: Contribution to journal › Article › Academic › peer-review
BACKGROUND: As a vulnerable population, children and adolescents with tuberculosis (TB) are faced with many challenges, even for those who live in low TB incidence countries. We aimed to evaluate factors associated with TB treatment outcomes allowing more focused interventions to support this population once diagnosed.
METHODS: A retrospective cohort study using a nationwide surveillance database was performed in children and adolescents (0-18 years) treated for TB in The Netherlands from 1993 to 2018. Logistic regression analyses were used to estimate adjusted odds ratios (aOR) for associated factors of mortality and lost to follow-up (LTFU).
RESULTS: Among 3253 eligible patients with known outcomes, 94.4% (95.9% children and 92.8% adolescents) were cured or completed treatment, 0.7% died during treatment and 4.9% were LTFU. There were no reported treatment failures. Risk factors of death included children aged 2-4 years (aOR=10.42), central nervous system TB (aOR=5.14), miliary TB (aOR=10.25), HIV coinfection (aOR=8.60), retreated TB cases (aOR=10.12), and drug-induced liver injury (aOR=6.50). Active case-finding was a protective factor of death (aOR=0.13). Risk factors of LTFU were adolescents aged 15-18 years (aOR=1.91), illegal immigrants (aOR=4.28), urban domicile (aOR=1.59), unknown history of TB contact (aOR=1.99), drug-resistant TB (aOR=2.31), single adverse drug reaction (ADR) (aOR=2.12), multiple ADRs (aOR=7.84) and treatment interruption >14 days (aOR=6.93). Treatment in recent years (aOR=0.94) and supervision by public health nurses (aOR=0.14) were protective factors of LTFU.
CONCLUSION: Highly successful treatment outcomes were demonstrated in children and adolescents routinely treated for TB. Special attention should be given to specific risk groups to improve treatment outcomes.
|Number of pages||12|
|Journal||European Respiratory Journal|
|Early online date||12-Sep-2019|
|Publication status||Published - 2020|