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Tuberculosis Treatment Outcomes among Children in Ethiopia: Systematic Review and Meta-Analysis

Wubet Birhan Yigzaw, Setegn Eshetie Kebede, Belay Tessema Belay

Background: Tuberculosis (TB) in children is increasingly recognized as a significant public health problem, and as an important component of the total global burden of tuberculosis. Tuberculosis among Ethiopian children is highly prevalent due to poor socio-economic conditions, malnutrition, over-crowding, HIV co-infection and high prevalence of TB in adult contacts. The World Health Organization (WHO) recommends that children with TB should be treated within the National TB Programmes (NTP) and notified through their routine reporting systems. Although with appropriate treatment 95% of children with PTB and non-severe EPTB could be treated successfully their outcome is largely unknown in developing countries including Ethiopia.

Methods: We identified a total of 1138 original articles from the initial computer-based search in PubMed, Hinari, Google Scholar untill may 20, 2017, and contacting authors and experts in the field. Of these, 64 full-text studies were eligible for review and 28 articles were used for meta-analysis, including a total study population of 10,929 patients from 7 regions of the country, namely Addis Ababa, Amhara, Afar, Gambella, oromia, South nations and nationalities people and Tigray. All of the studies were published in English, with study populations size varying from 32 to 2381, and undertaken between 2009 and 2017.

Results: The pooled treatment Success rate was 85% (CI: 82%-88%) with pooled cure and treatment completed rate of 8% (CI: 6%-11%) and 80% (CI: 76%-85%), respectively. The pooled unsuccessful treatment rate, lost to follow-up rate and death rate were 15% (CI: 12%-18%), 10% (CI: 7%-12%) and 6% (CI: 4%-7%), respectively.

Conclusion: The overall treatment success rate among children was similar with the general population. Close follow up is required for better outcome.