The pattern of pediatric tuberculosis and treatment outcomes from 2012 to 2016 in Erbil City, Iraq

1 Department of Medical Microbiology, College of Health Science, Hawler Medical University, Erbil, Iraq. * Correspondence: ahang.mawlood@hmu.edu. krd Introduction Tuberculosis (TB) is globally one of the major causes of mortality among children, especially in developing counties. Recent reports from the World Health Organisation (WHO) showed that from a total of 9 million patients with TB, approximately 10% have occurred in children. Additionally, it has been estimated that the annual deaths associated with pediatric TB were 210,000 cases. The prevalence ratio of pediatric TB is more than 40% in high-burden countries with a high incidence rate of tuberculosis. Therefore, over the last decade increased attentions have given to pediatric TB particularly in limited resource area. The diagnosis of TB in infants and children continues to be a real challenge for detection, diagnostic accuracy, and therapeutic options. The difficulty in sputum collection and low rate of microbiological confirmation are widely acknowledged. Therefore, detection of the clinical criteria of pediatric TB is essential to directly diagnose tuberculosis and to make an earlier control of the disease. WHO suggests that performing a routine examination for children living in close contact with an adult diagnosed with active TB is an important measure to improve the control of pediatric tuberculosis. Failure of the national TB control program is one of the factors that led to the development of pediatric TB. Background and objective: M. tuberculosis is one of the main causes of morbidity and mortality in many countries and is considered a priority global health problem. Although it is a curable disease, every year about nine million people develop active disease, and two million die from it. This study aimed to find the pattern of tuberculosis among children in Erbil city and determine the treatment outcomes of pediatric tuberculosis. Methods: From March 2012 to March 2016, 142 patients younger than 18 years with confirmed diagnosis of tuberculosis were registered and treated at the Chest and Respiratory Disease Centre in Erbil. The diagnosis of tuberculosis was performed based on routine tests at the center. AFB smear staining, GeneXpert assay, and culture methods when required for further confirmations using L-J media. Results: The total number of the studied records of tuberculosis was 729 during five years (2012-2016). More than half (55.6%) of patients aged ≤ 18 years were males. It is evident that the number of cases is increasing with the progress of years, but the difference was not significant between the years (P = 0.534). The death rate was 9.1% among patients of the whole sample, but no significant association was detected between age and outcome and was highest (22.7%) among patients aged 7-12 years (P = 0.142). Conclusion: Tuberculosis is still a very severe disease with high mortality rates in children. Early recognition of infection associated with correct early treatment, systematic entourage investigation, and chemoprophylaxis by isoniazide in all children under five years of age is essential for attempting to reduce these prognostic indices.