Mortality among Children with Tuberculosis in Malaysia

Aims: To describe the characteristics of children who succumbed to tuberculosis (TB) in Malaysia. Study Design: Retrospective record review with cross-sectional interview. Place and Duration of Study: All Malaysian hospitals with reported TB mortality among children, between January 2018 and December 2020. Methodology: We included all children under 15 years who succumbed to TB from 1st January 2018 to 31st December 2020 in Malaysia. We collected data from the TB Information System (MyTB) and subjects’ medical records. Parents were interviewed for further information. Results: Seventy-one deaths among children were identified from MyTB. Only 38 of the children’s medical records were available for review. From 71 children, 41 (57.7%) were females, 29 (40.8%) non-Malaysians, 43 (60.6%) had a BCG scar. Median age at death was 94 (5-179) months. From medical records of 38 children, common symptoms were cough (28, 73.7%), fever (25, 65.8%), and dyspnoea (20, 52.6%). Fifty-six (78.9%) of 71 children had abnormal chest x-ray, and 26 (36.6%) had positive acid-fast bacilli smear. Extra-pulmonary TB was diagnosed in 31.0% of them. Median duration between diagnosis to death was 9 days (0-280). Conclusion: Clinical and public health intervention could prevent complication and death from TB disease. Early detection leads to prompt treatment and increase of vaccination uptake prevents severe TB in young children.