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Factors associated with unsuccessful tuberculosis treatment outcome in children in four provinces of Mozambique

2026-12Artigo científico Acesso aberto
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dc.contributor.authorMbate-Mutemba, Criménia
dc.contributor.authorNunes, Elizabete
dc.contributor.authorMunyangaju, Isabelle
dc.contributor.authorRamos-Rincón, José Manuel
dc.contributor.authorJosé, Benedita
dc.contributor.authorMartins, Maria Do Rosário Fraga O.
dc.contributor.institutionInstituto de Higiene e Medicina Tropical (IHMT)
dc.contributor.institutionGlobal Health and Tropical Medicine (GHTM)
dc.contributor.institutionLaboratório Associado de Translacção e Inovação para a Saúde Global - LA Real (Pólo IHMT)
dc.contributor.institutionPopulation health, policies and services (PPS)
dc.contributor.pblSpringer Verlag
dc.date.accessioned2026-06-21T02:26:01Z
dc.date.available2026-06-21T02:26:01Z
dc.date.issued2026-12
dc.descriptionFunding text: This study was partially funded by national funds through FCT – Fundação para a Ciência e a Tecnologia, I.P., under the R&D unit Global Health and Tropical Medicine (UID/04413/2025) and the Associated Laboratory in Translation and Innovation Towards Global Health REAL (LA/P/0117/2020). Publisher Copyright: © The Author(s) 2026.
dc.description.abstractBackground: Tuberculosis (TB) remains a significant global public health challenge. Childhood TB treatment outcomes in Mozambique remain poorly understood. This retrospective cohort study aims to identify factors associated with unsuccessful outcomes in children. Methods: We analysed children (0–14 years) treated for TB between 2018 and 2021 in 16 selected health facilities. Logistic regression was undertaken to identify factors associated with unsuccessful outcomes reported as Odds ratios (ORs) with 95% confidence intervals. Results: During the study period, a total of 1,421 children were included (211 in 2018, 380 in 2019, 600 in 2020 and 230 in 2021). Of these, 33.7% (479) were aged 0–4 years, 37.1% (527) 5–9 years, and 29.2% (415) 10–14 years. Females accounted for 50.3% (715), and 25.8% (367) were HIV positive. Pulmonary tuberculosis was the predominant form, representing 96.1% (1,366), while Extrapulmonary Tuberculosis (EPTB) comprised 3.9% (55). Unsuccessful outcome occurred in 5.6% (79) children. In multivariable regression model, several factors were independently associated with unsuccessful treatment outcome. Children aged 5–9 years had significantly lower odds of unsuccessful outcomes compared with those aged 0–4 years (model 1: aOR: 0.49 95% CI: 0.27–0.88; p = 0.017 and model 2: aOR: 0.44 95% CI: 0.24–0.80; p = 0.007). PTB was also associated with lower odds of unsuccessful outcome (model 1: aOR 0.33; 95% CI 0.14–0.78; p = 0.011 and model 2: aOR 0.39; 95% CI 0.16–0.96; p = 0.039). Compared to children treated in Maputo city, those in Maputo province (aOR 0.29; 95% CI 0.14–0.60; p = 0.01), Nampula (aOR 0.16; 95% CI 0.07–0.36; p < 0.01) and Zambézia (aOR 0.06; 95% CI 0.02–0.15; p < 0.01) had significantly lower odds of an unsuccessful outcome. Conclusions: Young children and those with EPTB were associated with unsuccessful treatment. Provincial disparities suggest inequities in pediatric TB care. Strengthening prevention, early diagnosis, management in young children, and service equity are needed to improve outcomes.en
dc.description.versionpublishersversion
dc.description.versionepub_ahead_of_print
dc.format.extent1309398
dc.identifier.doi10.1186/s12879-026-13290-x
dc.identifier.issn2374-4235
dc.identifier.otherPURE: 165023810
dc.identifier.otherPURE UUID: cae02a17-00a9-4d97-9c32-45d5ffdfcbe2
dc.identifier.otherScopus: 105039846392
dc.identifier.otherWOS: 001773826300002
dc.identifier.otherPubMed: 41975300
dc.identifier.otherPubMedCentral: PMC13200302
dc.identifier.otherORCID: /0000-0002-7941-0285/work/218314762
dc.identifier.urihttp://hdl.handle.net/10362/203931
dc.identifier.urlhttps://www.scopus.com/pages/publications/105039846392
dc.language.isoeng
dc.peerreviewedyes
dc.subjectChildren
dc.subjectMozambique
dc.subjectTreatment outcomes
dc.subjectTuberculosis
dc.subjectInfectious Diseases
dc.subjectSDG 3 - Good Health and Well-being
dc.titleFactors associated with unsuccessful tuberculosis treatment outcome in children in four provinces of Mozambiqueen
dc.title.subtitlea retrospective cohort study, 2018–2021en
dc.typejournal article
degois.publication.issue1
degois.publication.titleBMC Infectious Diseases
degois.publication.volume26
dspace.entity.typePublication
rcaap.rightsopenAccess

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