@article{PAR00017109,
  title = {{O}utcome of children with presumptive tuberculosis in {M}barara, rural {U}ganda},
  author = {{B}onnet, {M}aryline and {N}ansumba, {M}. and {B}astard, {M}. and {O}rikiriza, {P}. and {K}yomugasho, {N}. and {N}ansera, {D}. and {B}oum, {Y}. and {B}eaudrap, {P}ierre de and {K}iwanuka, {J}. and {K}umbakumba, {E}.},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground: {M}ortality among children with presumptive tuberculosis ({TB}) empiric {TB} treatment can be high. {W}e describe the predictors of death among children with presumptive {TB}, and the relation between treatment and mortality. {M}ethods: {A} prospective cohort of children with presumptive {TB} who underwent clinical assessment, chest radiograph, tuberculin skin test and sputum bacterial tests for {TB} was followed up for 3 months. {TB} diagnosis was based on mycobacterial, clinical and radiologic findings. {P}redictors of deaths were determined using cox regression model. {R}esults: {O}f 360 children included in the analysis, 31.4% were younger than 2 years; 31.6% were {HIV} infected and 11.3% were severely malnourished. {O}ne hundred forty (38.9%) were diagnosed with {TB}, 18 (13%) of whom were bacteriologically confirmed. {A}t 3 months of follow up, 25 of 360 (6.9%) children had died: 15 of 140 (10.7%) were receiving {TB} treatment versus 10 of 220 (4.5%) were not receiving treatment ({P} = 0.025). {S}everely malnourished children [adjusted hazard ratio (a{HR}), 9.86; 95% confidence interval ({CI}): 3.11-31.23] and those with chest radiographs suggestive of {TB} (a{HR}, 4.20; 95% {CI}: 0.93-19.01) were more likely to die. {C}hildren receiving empiric {TB} treatment had an increased risk of death (a{HR}, 2.37; 95% {CI}: 1.01-5.55) compared with children without treatment after adjustment for age, sex, {HIV} status and {B}acillus {C}almette-{G}uerin ({BCG}) vaccination. {C}onclusions: {T}he high mortality in children receiving empirically {TB} treatment highlights the difficulty in diagnosing childhood {TB}, the increased likelihood of starting treatment in critically ill children and in children with chronic disease, and the possibility of misdiagnosis. {I}t strengthens the need to invest further in early {TB} detection and diagnosing nonsevere illness.},
  keywords = {tuberculosis ; treatment ; children ; mortality ; {OUGANDA}},
  booktitle = {},
  journal = {{P}ediatric {I}nfectious {D}isease {J}ournal},
  volume = {37},
  numero = {2},
  pages = {147--152},
  ISSN = {0891-3668},
  year = {2018},
  DOI = {10.1097/inf.0000000000001727},
  URL = {https://www.documentation.ird.fr/hor/{PAR}00017109},
}