Setting: The National Tuberculosis Programme, Mauritania.
Objective: To compare the diagnosis and treatment outcomes
of childhood tuberculosis (TB) cases (aged <15
years) registered between 2010 and 2015 inside and outside
Nouakchott, the capital city.
Design: This was a retrospective comparative cohort
study.
Results: A total of 948 children with TB were registered.
The registration rate was 10 times higher in Nouakchott.
The proportion of children among all TB cases was higher
inside than outside Nouakchott (7.5% vs. 4.6%, P <
0.01). Under-fives represented 225 (24%) of all childhood
TB cases, of whom 204 (91%) were registered in
Nouakchott. Extra-pulmonary TB was more common in
Nouakchott, while smear-negative TB was less common.
Treatment success was similar inside and outside Nouakchott
(national rate 61%). The principal unsuccessful outcomes
were loss to follow-up outside Nouakchott (21%
vs. 11%, P < 0.01) while transfers out were more common
in the city (25% vs. 14%, P = 0.01). Being aged <5
years (OR 1.2, 95%CI 1.1–1.5) was associated with an
unsuccessful outcome.
Conclusion: This study indicates problems in the diagnosis
and treatment of childhood TB in Mauritania, especially
outside the city of Nouakchott. We suggest
strengthening clinical diagnosis and management, improving
communications between TB treatment centres
and health services and pressing the TB world to develop
more accurate and easy-to-use diagnostic tools for
children.