Treatment outcomes and its determinants among the children with tuberculosis in a Tertiary Care Hospital.

Abstract

Objective: To determine tuberculosis (TB) treatment outcomes and identify its determinants. Study Design: Analytical, Cross-sectional study. Setting: Medical units and TB clinic of National Institute of Child Health (NICH), Karachi, Pakistan. Period: January 2025 to December 2025. Methods: A total of 172 children, aged 6 months to 15 years with clinically or bacteriologically diagnosed TB who received anti-TB therapy were analyzed. Management followed National TB Control Program guidelines with a 2-month intensive phase and continuation phase duration based on TB site. Outcomes were analyze applying chi-square of fisher’s exact test, while multivariable logistic regression analysis was used to determine predictors of successful treatment outcomes, with adjusted odds ration (aOR), and 95% confidence interval (CI). P<0.05 was taken as statistically significant. Results: Among 172 children, 94 (54.7%) were male, and the median age was 4.6 years (IQR 2.0–9.2). Pulmonary TB was diagnosed in 103 (59.9%), and bacteriological confirmation in 64 (37.2%) children. After excluding 23 (13.4%) lost to follow-up, and in remaining 149 children, 131 (87.9%) children achieved treatment success, while 12 (8.1%) died, and 6 (4.0%) failed. Reduced success was associated with previously treated TB aOR 0.31 (95%CI: 0.09–0.98, p=0.047), hypoalbuminemia aOR 0.33 (95%CI: 0.12–0.86, p=0.023), and human immunodeficiency virus (HIV) positivity aOR 0.09 (95%CI: 0.01–0.74, p=0.036). Conclusion: Treatment outcomes in children with TB were largely favourable, although death, treatment failure, and loss to follow-up remained clinically important. Prior TB treatment, HIV infection, and low serum albumin were associated with reduced treatment success.