Prevalence, Associated Risk Factors and Rifampicin Resistance Pattern of Pulmonary Tuberculosis Among Children at Debre Markos Referral Hospital, Northwest, Ethiopia

Abstract

Background

Tuberculosis presents a heightened threat to community health throughout the world but disproportionately afflicts low-income nations. In Ethiopia, TB is a significant health problem in children causing significant morbidity and mortality. Therefore, this study aimed to determine the prevalence, risk factors, and rifampicin resistance of pulmonary tuberculosis among children.

Methods

A hospital-based cross-sectional study was conducted on 384 children less than 15 years of age at Debre Markos Referral Hospital from February to May 2019. Sputum and gastric lavage samples were used to detect Mycobacterium tuberculosis and its rifampicin resistance pattern. MTB/RIF GeneXpert assay was used for the laboratory diagnosis.

Results

The prevalence of pulmonary tuberculosis and rifampicin resistance was 22 (5.73%) and 2 (0.52%), respectively. Educational status of the family (P = 0.02; AOR = 4.12; CI = 1.28–13.15), residence (P = 0.04; AOR = 3.09; CI =1.05–9.06), history of tuberculosis contact (P ≤ 0.001; AOR = 14.78; CI = 4.43–49.26), HIV infection (P ≤ 0.001; AOR = 5.51; CI = 1.72–17.7), malnourished status (P = 0.01; AOR = 4.11; CI = 1.33–12.65), duration of cough greater than 3 weeks (P = 0.04; AOR = 3.2; CI = 11.05–9.78), weight loss (P ≤ 0.001; AOR = 307.8; CI = 32–2980), and children with mucoid sputum (P = 0.02; AOR = 3.76; CI = 1.2–12.2) were significantly associated with tuberculosis infection.

Conclusion

This study showed a high prevalence of pulmonary tuberculosis infection among children. Residence, educational status of the family, contact history with tuberculosis cases, HIV, and malnutrition were risk factors for tuberculosis infection. Therefore, periodic surveillance of tuberculosis and assessing risk factors among children should be addressed. Moreover, a regular large scale survey should be conducted to assess the burden and intervene accordingly.

Keywords:

• tuberculosis
• rifampicin resistance
• children
• Mycobacterium tuberculosis
• MTB/RIF GeneXpert

Acknowledgments

We would like to thank the University of Gondar and study participants for the support given to conduct this study. We were also very grateful to thank all the health professionals and laboratory technicians working at Debremarkos hospital for all the support they gave us during the data collection and laboratory investigations.

Abbreviations

AOR, adjusted odds ratio; BMI, body mass index; CI, confidence interval; CSA, Central Statistical Agency; DBS, dry blood test; DNA, deoxyribonucleic acid; DR-TB, drug resistant tuberculosis; HIV, human immunodeficiency virus; MDR-TB, multi drug resistant; MOH, Ministry of Health; MTB, Mycobacterium tuberculosis; MUAC, mid upper arm circumference; PCC, probe check control; PCR, polymerase chain reaction; RR-TB, rifampicin resistant tuberculosis; RIF, rifampicin; RNA, ribonucleic acid; SPC, sample processing control; SPSS, Statistical Package for Social Science; TB, tuberculosis; WHO, World Health Organization.

Data Sharing Statement

All data generated or analyzed during this study were included in this manuscript. Data that support the findings of this study are also available from the corresponding author upon reasonable request.

Ethics Approval and Consent to Participate

This study was conducted by following the principles of the Declaration of Helsinki. Ethical clearance was obtained from the University of Gondar ethical review committee, and written permission was obtained from Debremarkos referral hospital administration. Before the enrolment of a patient in the study, written informed consent was obtained from parents or legal guardians. Additionally, the confidentiality of information was assured. Each confirmed TB case/positive findings were linked to TB OPD/healthy institutions to begin anti-TB treatment.

Consent for Publication

Not applicable

Author Contributions

All authors contributed equally to the conception, drafting, study design, execution, acquisition, analysis, and interpretation of data, write up and critically reviewing of the manuscript; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

The authors declare that they have no competing interests.