Mortality among Children with Tuberculosis in Malaysia
Maria Kamal *
Clinical Research Centre, Hospital Tunku Azizah, Ministry of Health Malaysia, Kuala Lumpur, Malaysia.
Sze Chiang Lui
Clinical Research Centre, Hospital Tunku Azizah, Ministry of Health Malaysia, Kuala Lumpur, Malaysia.
Then Moli Othayamoorthy
Clinical Research Centre, Hospital Tunku Azizah, Ministry of Health Malaysia, Kuala Lumpur, Malaysia.
Mohd Ihsani Mahmood
Disease Control Division, Ministry of Health Malaysia, Putrajaya, Malaysia.
Agnes Huei-Hwen Foo
Department of Paediatrics, Hospital Duchess of Kent, Ministry of Health Malaysia, Sandakan, Malaysia.
Nik Khairulddin Nik Yusoff
Department of Paedatrics, Hospital Raja Perempuan Zainab II, Ministry of Health Malaysia, Kota Bharu, Malaysia.
Ke Juin Wong
Department of Paediatrics, Hospital Wanita dan Kanak-kanak Sabah, Ministry of Health Malaysia, Likas, Malaysia.
Jeyaseelan P Nachiappan
Department of Paediatrics, Hospital Raja Permaisuri Bainun, Ministry of Health Malaysia, Ipoh, Malaysia.
Juan Loong Kok
Department of Paediatrics, Hospital Umum Sarawak, Ministry of Health Malaysia, Kuching, Malaysia.
Andrea Yu-Lin Ban
Faculty of Medicine, Hospital Canselor Tunku Muhriz UKM, Cheras, Malaysia.
Hui Lynn Khoo
Department of Paediatrics, Hospital Lahad Datu, Ministry of Health Malaysia, Lahad Datu, Malaysia.
Thiyagar Nadarajaw
Department of Paediatrics, Hospital Sultanah Bahiyah, Ministry of Health Malaysia, Alor Setar, Malaysia.
Hafizah Zainuddin
Department of Paediatrics, Hospital Pengajar Sultan Zainal Abidin, Kuala Nerus, Malaysia.
Chee Kong Tan
Department of Paediatrics, Hospital Labuan, Ministry of Health Malaysia, Labuan, Malaysia.
Noor Hafiza Noordin
Department of Paediatrics, Hospital Cyberjaya, Ministry of Health Malaysia, Cyberjaya, Malaysia.
Noorul Afidza Muhammad
Department of Internal Medicine, Hospital Sultan Idris Shah Serdang, Ministry of Health Malaysia, Kajang, Malaysia.
Raja Aimee Raja Abdullah
Department of Paediatrics, Hospital Pulau Pinang, Ministry of Health Malaysia, Georgetown, Malaysia.
Baizura Jamaluddin
Department of Paediatrics, Hospital Kajang, Ministry of Health Malaysia, Kajang, Malaysia.
Janet Yeow Hua Hong
Department of Paediatrics, Hospital Putrajaya, Ministry of Health Malaysia, Putrajaya, Malaysia.
Saiful Rijal Muhammad
Department of Paediatrics, Hospital Taiping, Ministry of Health Malaysia, Taiping, Malaysia.
Zuraidah Abdul Latif
Department of Paediatrics, Hospital Ampang, Ministry of Health Malaysia, Ampang, Malaysia.
Zainah Shaikh Hedra
Department of Paediatrics, Hospital Sultanah Nora Ismail, Ministry of Health Malaysia, Batu Pahat, Malaysia.
Tengku Saifudin Tengku Ismail
KPJ Tawakkal KL Specialist Hospital, Kuala Lumpur, Malaysia.
Asiah Kassim
Clinical Research Centre, Hospital Tunku Azizah, Ministry of Health Malaysia, Kuala Lumpur, Malaysia and Department of Paediatrics, Hospital Tunku Azizah, Ministry of Health Malaysia, Kuala Lumpur, Malaysia.
*Author to whom correspondence should be addressed.
Abstract
Aims: To describe the characteristics of children who succumbed to tuberculosis (TB) in Malaysia.
Study Design: Retrospective record review with cross-sectional interview.
Place and Duration of Study: All Malaysian hospitals with reported TB mortality among children, between January 2018 and December 2020.
Methodology: We included all children under 15 years who succumbed to TB from 1st January 2018 to 31st December 2020 in Malaysia. We collected data from the TB Information System (MyTB) and subjects’ medical records. Parents were interviewed for further information.
Results: Seventy-one deaths among children were identified from MyTB. Only 38 of the children’s medical records were available for review. From 71 children, 41 (57.7%) were females, 29 (40.8%) non-Malaysians, 43 (60.6%) had a BCG scar. Median age at death was 94 (5-179) months. From medical records of 38 children, common symptoms were cough (28, 73.7%), fever (25, 65.8%), and dyspnoea (20, 52.6%). Fifty-six (78.9%) of 71 children had abnormal chest x-ray, and 26 (36.6%) had positive acid-fast bacilli smear. Extra-pulmonary TB was diagnosed in 31.0% of them. Median duration between diagnosis to death was 9 days (0-280).
Conclusion: Clinical and public health intervention could prevent complication and death from TB disease. Early detection leads to prompt treatment and increase of vaccination uptake prevents severe TB in young children.
Keywords: Childhood tuberculosis, tuberculosis mortality in children, paediatric tuberculosis mortality