Factors associated with unfavorable treatment outcomes among pediatric tuberculosis cases in Harare, Zimbabwe during 2013-2017

Background Historical neglect of pediatric tuberculosis (TB), compounding the absence of a universally effective vaccine, highlights the importance of successful treatment in combating the global epidemic. Furthermore, compliance with international standards of pediatric TB treatment remains unknown in many high-burden, resource-limited settings. Methods In this cross-sectional study, using TB surveillance data, we assessed the treatment outcomes among 853 pediatric TB cases ( Results Of these 853 analyzed cases, 57% were either cured or had completed treatment. In a model accounting for confounding variables, hospital center and pretreatment sputum smear were associated with unfavorable treatment outcome. Cases from Beatrice Road Infectious Disease Hospital were four times as likely to have an unfavorable outcome compared with those from Wilkins Infectious Disease Hospital (adjusted odds ration [aOR]: 4.0; 95% CI 2.9-5.5). Children whose pretreatment sputum smear was positive were 2.4 times as likely to have an unfavorable outcome as those who were negative (aOR: 2.4; 95% CI 1.7-3.6). Conclusion Pediatric TB case management needs to be improved, especially among those with a positive pretreatment sputum smear. Efforts to address TB treatment outcome disparities between clinical settings in high-burden settings, such as Harare, Zimbabwe, are essential in improving global TB control.