TB Research

Management of tuberculosis infection in Victorian children: A retrospective clinical audit of factors affecting treatment completion

Holmes RH, Sun S, Kazi S, Ranganathan S, Tosif S, Graham SM, Graham HR

PloS one · 2022-10

Abstract

Background Tuberculosis preventive treatment (TPT) is strongly recommended for children following infection with Mycobacterium tuberculosis because of their high risk of progression to active tuberculosis, including severe disseminated disease. We describe the implementation of TPT for children and adolescents with evidence of tuberculosis infection (TBI) at Victoria's largest children's hospital and examine factors affecting treatment completion. Methods We conducted a retrospective clinical audit of all children and adolescents aged Results Of 402 participants with TBI, 296 (74%) met the criteria for treatment "complete". The most common TPT regimen was six months of daily isoniazid (377, 94%). On multivariate logistic regression analysis, treatment completion was more likely among children and adolescents who had refugee health screening performed (OR 2.31, 95%CI 1.34-4.00) or who were also treated for other medical conditions (OR 1.67 95%CI 1.0-2.85), and less likely among those who experienced side-effects (OR 0.32, 95%CI 0.11-0.94). However, TPT was generally well tolerated with side-effects reported in 15 participants (3.7%). Conclusion Identification of factors associated with TPT completion and deficiencies in the existing care pathway have informed service provision changes to further improve outcomes for Victorian children and adolescents with TBI.

MeSH terms

  • Humans
  • Tuberculosis, Lymph Node
  • Isoniazid
  • Antitubercular Agents
  • Retrospective Studies
  • Adolescent
  • Child
  • Clinical Audit
  • Latent Tuberculosis
  • Drug-Related Side Effects and Adverse Reactions