The epidomiology of childhood tubercolusis and clinical outcomes in South Africa 2008 - 2012.

Abstract

Tuberculosis (TB) in children, particularly in those under five years is regarded as an indicator of there being an infectious pool in the community. The World Health Organization (WHO) has focused on childhood tuberculosis, recognizing its contribution to the overall TB burden and to child survival. The Roadmap for Childhood Tuberculosis identifies the need to know the incidence of childhood TB in order to design and implement specific public health interventions to limit the spread of the disease and orientate health services in early TB detection, treatment and retention in care to prevent on-going transmission. Aim The aim of this research is to investigate the epidemiology of childhood TB in South Africa (SA) from 2008 to 2012 in order to inform TB control policy and practice. Methods An observational analytical cross sectional study design was used. The Electronic TB Register was used as the source of the data. Records from 1 January 2008 to 31 December 2012 were used. STATA and Excel were used to describe and analyse data. Results The proportion of children aged 0 to 14 years with TB in SA has fluctuated between 19.2% in 2008, reaching a high of 22.3% in 2009 and reducing to 18.8% in 2012. Testing children with TB for HIV has increased steadily from 17.9% in 2008 to 68.5% in 2012. The HIV prevalence in tested cases aged ten to fourteen years in 2012 was the highest at 42.6% with the lowest prevalence found in the zero to four year age group in 2012 of 16.7%. In analysing treatment outcomes, the children aged five to nine years had 21% (0.79) less risk of death compared to the children less than 5 years whereas the age group ten to fourteen had 1.33 times the risk of death.