Evidence map›Paper›PMID 41847575›Full record

ArticlePublic health action2026

High levels of unfavourable treatment outcomes in children with drug-sensitive TB in Sierra Leone.

N Sesay, I F Kamara, A M V Kumar, P Thekkur, A A Alwani, B D Fofanah, A R Y Kamara, A Bah, L Farma-Grant, M A Sesay and 8 more

Abstract read
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In one paragraph

Article in Public health action, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors.

N SesayGovernment of Sierra Leone, Ministry of Health, University of Sierra Leone Teaching Hospital Complex, Ola During Children's Hospital, Freetown, Sierra Leone.
I F KamaraWorld Health Organization Country Office, Freetown, Sierra Leone.
A M V KumarCentre for Operational Research, International Union Against Tuberculosis and Lung Disease, Paris, France.
P ThekkurCentre for Operational Research, International Union Against Tuberculosis and Lung Disease, Paris, France.
A A AlwaniCentre for Operational Research, International Union Against Tuberculosis and Lung Disease, Paris, France.
B D FofanahWorld Health Organization Country Office, Freetown, Sierra Leone.
A R Y KamaraGovernment of Sierra Leone, Ministry of Health, Freetown, Sierra Leone.
A BahGovernment of Sierra Leone, Ministry of Health, University of Sierra Leone Teaching Hospital Complex, Ola During Children's Hospital, Freetown, Sierra Leone.
L Farma-GrantGovernment of Sierra Leone, Ministry of Health, Directorate of National Child Health Programme, Ministry of Health, Freetown, Sierra Leone.
M A SesayGovernment of Sierra Leone, Ministry of Health, Freetown, Sierra Leone.
W K LahaiGovernment of Sierra Leone, Ministry of Health, Freetown, Sierra Leone.
J A KoromaGovernment of Sierra Leone, Ministry of Health, Directorate of National Leprosy and Tuberculosis Programme, Ministry of Health, Freetown, Sierra Leone.
S M TengbeGovernment of Sierra Leone, Ministry of Health, University of Sierra Leone Teaching Hospital Complex, Ola During Children's Hospital, Freetown, Sierra Leone.
F KanuGovernment of Sierra Leone, Ministry of Health, Freetown, Sierra Leone.
G AmehWorld Health Organization Country Office, Freetown, Sierra Leone.
S M KannehGovernment of Sierra Leone, Ministry of Health, Freetown, Sierra Leone.
R ZachariahUNICEF, UNDP, World Bank, WHO Special Programme for Research and Training in Tropical Diseases (TDR), Geneva, Switzerland.
M MahmoudGovernment of Sierra Leone, Ministry of Health, Directorate of National Leprosy and Tuberculosis Programme, Ministry of Health, Freetown, Sierra Leone.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

settingOla During Children's Hospital, a tertiary-level paediatric facility affiliated with a university and located in Freetown, Sierra Leone. No published studies from Sierra Leone have evaluated treatment outcomes in children (<15 years) with drug-sensitive TB (DS-TB).

objectiveTo assess compliance with national TB treatment guidelines and evaluate treatment outcomes among children with DS-TB.

designA non-concurrent cohort study, utilising routinely collected secondary patient data from TB treatment master cards. Poisson regression was done to calculate adjusted relative risks (aRR).

resultsOf 689 children, 95% received treatment regimens compliant with national guidelines. However, only 32% achieved favourable outcomes, while 68% had unfavourable outcomes (7% death, 30% loss to follow-up, 31% not evaluated). HIV co-infection (aRR = 1.2) and HIV-unknown status (aRR = 1.5), residence outside urban areas (aRR = 1.3), and extra-pulmonary TB (aRR = 1.2) were significantly associated with unfavourable outcomes. Children treated in 2023 (aRR = 0.7) and 2024 (aRR = 0.6) had better outcomes than those in 2022.

conclusionDespite high compliance with treatment protocols, paediatric TB outcomes were alarmingly unfavourable. Strengthening follow-up systems and data recording, integrating TB-HIV services, and decentralising care are critical to improving outcomes in this vulnerable population.

Indexed as

mortalityoperational researchSORT ITtuberculosisuniversal health coverageunsuccessful outcomes

Identifiers

PMID41847575
PMCPMC12991600

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.