Diagnostic methods and treatment outcomes for TB in children under 15 years in Kisii County, 2012-2016
Background: Diagnosis of TB in children poses a challenge due to the paucibacillairy nature of TB and difficulties in making a bacteriological confirmation. Globally, the TB burden in children is unknown with WHO estimating that they account for 10‐15% of all cases. In Kenya, children contributed to 8.5% of all notified TB cases in 2016.
Objective: To describe the diagnostic methods and treatment outcomes among children aged<15 years in Kisii County, 2012‐2016.
Design: A descriptive analysis of children aged <15 years in Kisii County diagnosed and notified of TB to the National TB program.
Results: We abstracted 825 records of children:217 in 2012,156 in 2013,164 in 2014,136 in 2015 and 152 in 2016.The median age was 8(IQR 2‐13) years with a male: female of ratio 1:1. The 10‐15 years age‐group accounted for 43% (351) while those aged<1year accounted for 10% (81). HIV testing was done among 806 (98%) with a TB/HIV co‐infection of 31% and 96% ART initiation rate. Bacteriological and clinical diagnosis was done for 129/825 (16%) and 696/825(84 %). Gene Xpert was done for 28/825 (3%) in 2016 and 1/825 in 2012. Overall, for the period 2012‐2015, the treatment success rate (TSR) was 96%
Conclusion: There has been a decline in notification rates over time, however, it was not clear whether this was due to absence of disease or improved use of diagnostics which requires further research. Older children accounted for majority of the cases diagnosed for TB. Most of the children in the younger age groups <5 years were initiated on treatment based on clinical diagnosis or a chest X‐ray and hence a need to support health workers and health system in general on acquisition of sputum specimen in this younger age group.