Objective: To investigate the case fatality rate and risk factors for childhood tuberculosis mortality during treatment in low-income health facilities. Methods: In this retrospective case series study, we used secondary hospital data extracted from tuberculosis treatment medical records at Mulago Hospital Pediatric Tuberculosis clinic, Kampala, Uganda. Children aged 0-14years treated for Tuberculosis at this hospital from 2012 to 2015 were included in this study. Results: We enrolled 494 children into the study and 83(16.8%) were lost to follow up. The analytic sample consisted of 411 children followed up. The proportion of missing observations ranged from 0% to 53% among variables. More males 225(54.7%) and children aged 0-4years, 252(61.5%) were enrolled. Children without BCG vaccine and HIV positive children with failure to thrive were more likely to be lost to follow up. The childhood case fatality rate was 9.3% but estimates varied from 7.7% -24.5% depending on assumptions about mortality for those lost to follow up. The multivariable logistic regression model showed that children with a negative tuberculin skin test were less likely to survive TB, p-value = 0.04; [OR = 0.2, 95% CI 0.04, 0.9]. Conclusion: In settings with high TB burden, like Uganda, we need complete clinical data on childhood TB to gain more precise estimates case-fatality and its risk factors. This is vital in monitoring progress and informing policy makers.
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