Abstract

Purpose Statement: This project assessed the demographics, clinical features and treatment outcomes of pediatric tuberculosis (TB) at an urban children’s hospital in Haiti in 2023.

Background: TB is a global health problem and is the second leading cause of death after COVID-19. Ending the TB epidemic by 2035 is a health target of the United Nations Sustainable Development Goals (SDGs). In 2022, the World Health Organization (WHO) estimated 1.25 million children became ill with TB. Haiti has the highest rate of TB in the Western Hemisphere with a 2023 incidence rate of 149 cases per 100,000 people compared to the United States with less than 4 cases per 100,000 people. Children are more likely to get sick with TB than adults. Contact with known adult TB cases is an important risk factor for children.

Methods: This is a retrospective analysis of children aged 14 and younger diagnosed with any form of TB at an urban children’s hospital in 2023. Medical record reviews were conducted using a standardized collection form. Demographics, clinical characteristics, diagnostic testing and treatment regimen data of these patients were analyzed. This analysis was approved by the National Director of the hospital.

Results: A total of 32 pediatric patients were included in this analysis and all presented with symptoms of TB. Extrapulmonary TB was the most common clinical presentation (n=23). There were more males (56%) than females, 60% of the patients were younger than 5 years old, and 75% had a history of receiving Bacillus Calmette-Guérin (BCG) vaccination. In-patient hospitalization of three patients was required for more than two months due to severe malnutrition. There were no reported deaths. One child, two years old, was also diagnosed with HIV. Twenty-eight patients successfully completed their treatment with intense caregiver education. All efforts for follow-up were attempted by the institution utilizing community health agents; however displacement due to the socio-political situation played a key role in the failure of completing treatment for four of the patients.

Conclusions: This analysis provided valuable insights into outcomes and associated factors related to pediatric TB. Nursing implications include ensuring adherence to treatment plans by providing support and ongoing education to patients and family members. The analysis may help the hospital in measuring progress towards the SDGs of the 2035 World Health Organization's End TB strategy.

Notes

References:

Maphalle LNF, Michniak-Kohn BB, Ogunrombi MO, Adeleke OA. (2022). Pediatric Tuberculosis Management: A Global Challenge or Breakthrough? Children, 9(8):1120. https://doi.org/10.3390/children9081120

Pan American Health Organization. (2024, October 4). Public Health Situation Analysis. Haiti. https://www.paho.org/en/documents/public-health-situation-analysis-haiti-4-octobre-2024

Verkuijl, S., Bastard, M., Brands, A., Viney, K., Masini, T., Mavhunga, F., Floyd, K., & Kasaeva, T. (2024). Global reporting on TB in children and adolescents: how far have we come and what remains to be done?. IJTLD open, 1(1), 3–6. https://doi.org/10.5588/ijtldopen.23.0529

Villarreal, E. G., Estrada-Mendizábal, R. J., Ramos-Barrera, E., Treviño-Valdez, P. D., & Tamez-Rivera, O. (2022). Pediatric Tuberculosis in Mexican Children: A Retrospective Analysis of 100 Patients. Open Forum Infectious Diseases, 9(Supplement 2). https://doi.org/10.1093/ofid/ofac492.1272

Description

Tuberculosis is one of the leading killers of global infectious diseases. Young children with TB disease may have serious consequences due to their immature immune systems. By attending this session, the learner will discover the 2023 epidemiological trends and nursing implications of pediatric TB at an urban hospital in Haiti.

Author Details

Jocelyne Arnoux Fréderic, MSN; Margarett Alexandre, PhD, RN, MS, FNYAM; Becky M. Baird, MSN, BSN; Ellen L. Palmer, PhD, RN; Mary Gilliland, PhD, RN; Charla Edwards, MPH, BSN

Sigma Membership

Delta Theta

Type

Presentation

Format Type

Text-based Document

Study Design/Type

Other

Research Approach

Other

Keywords:

Public and Community Health, Sustainable Development Goals, Acute Care, Pediatric Tuberculosis, Haiti

Conference Name

36th International Nursing Research Congress

Conference Host

Sigma Theta Tau International

Conference Location

Seattle, Washington, USA

Conference Year

2025

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.

Review Type

Abstract Review Only: Reviewed by Event Host

Acquisition

Proxy-submission

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Pediatric Tuberculosis at an Urban Hospital in Haiti: Nursing Implications

Seattle, Washington, USA

Purpose Statement: This project assessed the demographics, clinical features and treatment outcomes of pediatric tuberculosis (TB) at an urban children’s hospital in Haiti in 2023.

Background: TB is a global health problem and is the second leading cause of death after COVID-19. Ending the TB epidemic by 2035 is a health target of the United Nations Sustainable Development Goals (SDGs). In 2022, the World Health Organization (WHO) estimated 1.25 million children became ill with TB. Haiti has the highest rate of TB in the Western Hemisphere with a 2023 incidence rate of 149 cases per 100,000 people compared to the United States with less than 4 cases per 100,000 people. Children are more likely to get sick with TB than adults. Contact with known adult TB cases is an important risk factor for children.

Methods: This is a retrospective analysis of children aged 14 and younger diagnosed with any form of TB at an urban children’s hospital in 2023. Medical record reviews were conducted using a standardized collection form. Demographics, clinical characteristics, diagnostic testing and treatment regimen data of these patients were analyzed. This analysis was approved by the National Director of the hospital.

Results: A total of 32 pediatric patients were included in this analysis and all presented with symptoms of TB. Extrapulmonary TB was the most common clinical presentation (n=23). There were more males (56%) than females, 60% of the patients were younger than 5 years old, and 75% had a history of receiving Bacillus Calmette-Guérin (BCG) vaccination. In-patient hospitalization of three patients was required for more than two months due to severe malnutrition. There were no reported deaths. One child, two years old, was also diagnosed with HIV. Twenty-eight patients successfully completed their treatment with intense caregiver education. All efforts for follow-up were attempted by the institution utilizing community health agents; however displacement due to the socio-political situation played a key role in the failure of completing treatment for four of the patients.

Conclusions: This analysis provided valuable insights into outcomes and associated factors related to pediatric TB. Nursing implications include ensuring adherence to treatment plans by providing support and ongoing education to patients and family members. The analysis may help the hospital in measuring progress towards the SDGs of the 2035 World Health Organization's End TB strategy.