title: Childhood tuberculosis and its treatment outcomes in Addis Ababa: a 5-years retrospective study.
abstract: BACKGROUND
  Tuberculosis (TB) remains a significant public health problem leading to high morbidity and mortality both in adults and children. Reports on childhood TB and its treatment outcome are limited. In this retrospective study, we analyzed the epidemiology and treatment outcomes of TB among children in Addis Ababa.
  
  
  METHODS
  Children registered for TB treatment over 5 years (2007 to 2011) were included in the analysis. Demographic and clinical data including treatment outcomes were extracted from TB unit registers of 23 health centers in Addis Ababa. Multivariate logistic regression was used to identify predictors of poor treatment outcomes.
  
  
  RESULTS
  Among 41,254 TB patients registered for treatment at the 23 health centers, 2708 (6.6%) were children. Among children with TB, the proportions of smear positive PTB, smear negative PTB and EPTB were 9.6%, 43.0% and 47.4%, respectively. Treatment outcomes were documented for 95.2% of children of whom 85.5% were successfully treated while rates of mortality and defaulting from treatment were 3.3% and 3.8%, respectively. The proportion of children with TB tested for HIV reached 88.3% during the final year of the study period compared to only 3.9% at the beginning of the study period. Mortality was significantly higher among under-five children (p < 0.001) and those with HIV co-infection (p < 0.001). On multivariate logistic regression, children 5-9 years [AOR = 2.50 (95% CI 1.67-3.74)] and 10-14 years [AOR = 2.70 (95% CI 1.86-3.91)] had a significantly higher successful treatment outcomes. On the other hand, smear positive PTB [AOR = 0.44 (95% CI 0.27-0.73), HIV co-infection (AOR = 0.49(95% CI 0.30-0.80)] and unknown HIV sero-status [AOR = 0.60 (95% CI 0.42-0.86)] were predictors of poor treatment outcomes.
  
  
  CONCLUSIONS
  The proportion of childhood TB in this study is lower than the national estimate. The overall treatment success rate has met the WHO target. Nonetheless, younger children (< 5 years), children with smear positive PTB and those with HIV co-infection need special attention to reduce poor treatment outcomes among children in the study area.
authors.forename: Dereje
authors.initials: D
authors.lastname: Hailu
authors.forename: Woldaregay Erku
authors.initials: WE
authors.lastname: Abegaz
authors.affiliation: Aklilu Lemma Institute of Pathobiology, Addis Ababa University, P,O,Box 1176, Addis Ababa, Ethiopia. mulg2002@yahoo.com.
authors.forename: Mulugeta
authors.initials: M
authors.lastname: Belay
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005002:Ethiopia; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014376:Tuberculosis / Q000188:drug therapy* / Q000453:epidemiology*; D014504:Urban Health