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Description
Tuberculosis (TB) remains a leading cause of childhood morbidity and mortality, yet data on treatment outcomes and their determinants in Northern Ghana are limited. This study examined the prevalence, trends, and determinants of unsuccessful treatment outcomes among children with TB at Tamale Teaching Hospital from 2016 to 2024. A retrospective review of secondary data was conducted on children (<15 years) diagnosed with TB at the Tamale Teaching Hospital from 2016 to 2024. Data were extracted from the National Tuberculosis Program registers. Treatment outcomes were defined according to WHO guidelines. Modified Poisson regression with robust standard errors was employed to examine the risk of unsuccessful TB treatment outcomes, while logistic regression was used for sensitivity analysis. The data analyses were done using Stata/SE version 16. The study results showed that children with confirmed outcomes accounted for 233 (12.6%) of the total tuberculosis cases registered during the study period. The median age was 5 years (IQR: 2–10), with the majority being males, 58.4%. Pulmonary TB accounted for 63.5% of cases, while 36.5% were extra-pulmonary. TB/HIV co-infection prevalence was 13.7%. The overall treatment success rate was 75.5% (176/233). Unsuccessful outcomes occurred in 24.5% (57/233), comprising 11.2% deaths and 13.3% loss to follow-up, with no treatment failures recorded. In a multivariable regression model, children under 1 year (aRR: 3.04; 95% CI: 1.13–8.23), those aged 5–9 years (aRR: 3.51; 95%CI: 1.63-7.57), and rural residents (aOR: 2.19; 95% CI: 1.10-4.33) were at significantly higher risk of unsuccessful outcomes. Logistic regression sensitivity analyses confirmed these associations. No significant associations were found with sex, HIV status, patient category, or disease classification. In conclusion, nearly one in four children with TB at Tamale Teaching Hospital experienced unsuccessful treatment outcomes, mainly due to death and loss to follow-up. Younger age and rural residence were strong predictors of poor outcomes. Strengthening early diagnosis, decentralising care, and implementing targeted adherence support, particularly for rural families and younger children, are essential to improve childhood TB outcomes in Northern Ghana.