Clinical Pediatric Dermatology Open Access

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Risk factors for bad evolution in children hospitalized at Saint Damien hospital for pulmonary tuberculosis, January 2015 to December 2017

Lynda Taina Abicher

Background: In 2017, tuberculosis was still a major public health concern in some countries, as Haiti. In 2016, Haiti counted 20 000 cases of tuberculosis among which 2 600 pediatric cases. In children the diagnosis is very challenging and relies on a careful history of exposure, clinical examination and relevant investigations. Unfortunately, bacteriological confirmation is not always conclusive, and then the diagnosis stays presumptive: based on the clinical evaluation and/or exposure’s history, creating a delay of treatment. Now begs the question: What is the influence of the diagnosis methods on the prognosis? This study objective is to analyze the association of presumptive diagnosis and other risk factors with a poor evolution of pediatric inpatients admitted for tuberculosis at Saint Damien hospital.

Design: A case-control study was conducted from January 2015 to December 2017. Cases were any child less than 14-year-old treated for tuberculosis, dead or without any clinic improvement after the intensive phase of the treatment. Control represented any child with a satisfying clinical improvement. ODD ratio with a confidence interval of 95% were calculated and integrated into a multivariate analysis. Confirmed diagnosis was defined as a positive bacteriological exam or a positive Gene-Xpert for tuberculosis. Statistical tests chi2 and Fisher were realized for categorical variables.