Hospitalization for tuberculosis in children and adolescents: clinical, epidemiological characteristics and post-treatment sequelae at a referral center in Brazil

BACKGROUND: Tuberculosis in children may require hospitalization and can be associated with the development of sequelae even after completion of antituberculosis treatment, with potential long-term impacts on the health of children and adolescents. METHODS: This observational, longitudinal study was based on the review of medical records of children and adolescents hospitalized for tuberculosis at a referral center in Brazil. Clinical and epidemiological characteristics, care pathways, and the occurrence of post-treatment sequelae were described. Bivariate and multivariable analyses were performed to identify factors associated with the development of sequelae. RESULTS: A total of 87 patients were included, predominantly of mixed race, of both sexes, with a median age of 6-years. After hospital discharge, 92.0% remained under follow-up at the referral center. Among these patients, 88.8% achieved a cure and 11.2% discontinued treatment. Among patients who were cured, 46.5% developed sequelae after treatment completion. The presence of sequelae was associated with age ≥ 10-years, pulmonary tuberculosis, and markers of greater disease severity during hospitalization, including the need for invasive mechanical ventilation and longer length of hospital stay. CONCLUSIONS: Despite the high cure rate, a substantial proportion of children and adolescents developed post-tuberculosis sequelae. These findings highlight the need for a comprehensive approach, including post-treatment and multidisciplinary follow-up, centered on children and adolescents, to reduce morbidity and long-term functional impairment across the life course.