Epidemiology of Tuberculosis in pediatrics and variables associated with loss to follow-up

Abstract

Loss to follow-up (LTFU) in tuberculosis (TB) patients endangers their lives, facilitates disease transmission, and contributes to the development of drug resistance.

Objective: To describe the epidemiology of a cohort of children diagnosed with TB in a high-complexity pediatric hospital and to identify variables associated with LTFU.

Patients and Method: A retrospective cohort study was conducted at a tertiary care hospital in Buenos Aires, Argentina. Patients aged ≥ 30 days to ≤ 16 years diagnosed with TB during 2022–2023 were included. Patient characteristics were compared based on whether they experienced LTFU. STATA 18 was used for statistical analysis.

Results: 197 patients met the inclusion criteria. The median age was 11 years (IQR 7–14). 79% consulted due to symptoms, while 20% did so due to contact with a TB case. TB was classified as exclusively pulmonary in 60%, extrapulmonary in 11%, and both in 29%. Microbiological confirmation was obtained in 59% of cases. Drug resistance was identified in 5% of patients. 19% experienced LTFU. In the multivariate analysis, patients who did not report symptoms compatible with TB at the first consultation had a higher risk of LTFU (ORa 3.27, 95%CI 1.55-6.88; p = 0.030).

Conclusions: In this cohort of children with TB, a high rate of microbiological confirmation was observed. 19% were lost to follow-up. TB diagnosed in children who did not report symptoms at the first consultation was identified as a risk factor for LTFU.