Implementation of Tuberculosis (TB) Services For Children Living With HIV in US President's Emergency Plan For AIDS Relief-supported Programs in 16 High TB/HIV-burden Countries in Sub-Saharan Africa.

Details

• Alternative Title:
  AIDS (London, England), 2026, v. 40, no. 1: Implementation of Tuberculosis (TB) Services For Children Living With HIV in US President's Emergency Plan For AIDS Relief-supported Programs in 16 High TB/HIV-burden Countries in Sub-Saharan Africa.
• Journal Article:
  AIDS (London, England)
• Personal Author:
  Moore, Brittany K. ; O'Connor, Stephanie ; Sato, Kimi ; Briceño'Robaugh, Rebeca I. ; D'Auvergne, Cleophas ; Motebang, Maletsatsi ; Maphosa, Talent ; Mutisya, Immaculate ; Nyabiage, Lennah ; Teferi, Wondimu ; Feleke, Beniam ; Nwagagbo, Flora ; Vilakazi-Nhlapo, Kgomotso ; Shah, Neha ; Wolf, Hilary T. ; Pierre, Paul ; Sabanda, Qinisile ; Motlhaoleng, Katlego ; Paulin, Heather ; Kindra, Gupreet ; Agathis, Nickolas T.
• Description:
  We assessed implementation of tuberculosis (TB) services among children living with HIV (CLHIV) (<15 years) in 16 African countries supported by US President's Emergency Plan for AIDS Relief (PEPFAR) between October 2018 and September 2022 fiscal year (FY) 2019-FY2022).
  
  We reviewed PEPFAR TB indicators describing symptom screening, treatment initiation, and TB preventive treatment (TPT) initiation and completion among CLHIV. We describe performance of these measures at semi-annual time points from FY2019 to FY2022 with stratification by age, sex, geographic region, and antiretroviral therapy (ART) status for FY2022.
  
  During FY2019-FY2022, the proportion of CLHIV with a positive TB symptom screen was low, ranging from 2.5 to 4.1%, while TB treatment initiation among those who screened positive fluctuated from 19 to 43%. Similarly, TPT initiation among CLHIV newly initiating ART fluctuated during this time, ranging from 13 to 37%, while TPT completion rose from 55 to 85%. In 2022, 80% of CLHIV were screened for TB and 3.6% had a positive symptom screen. Among those, 15% of CLHIV already on ART and 40% of CLHIV newly initiating ART were started on TB treatment. In 2022, among CLHIV newly initiating ART, 37% started TPT within 6 months, and 84% completed the full course of TPT.
  
  TB screening and screening positivity were suboptimal. CLHIV starting TB treatment following positive symptom screen was higher than expected, especially among those newly initiating ART. Most CLHIV did not start TPT within 6 months of ART initiation. These findings suggest that programs are missing opportunities to diagnose and prevent TB in CLHIV.
• Content Notes:
  Author manuscript
• Subjects:
  • Humans
  • HIV Infections
  • Tuberculosis
  • Child
  • Adolescent
  • Male
  • Female
  • Child, Preschool
  • Infant
  • Mass Screening
  More +
• Keywords:
  • children
  • HIV
  • pediatric
  • tuberculosis
  • tuberculosis case finding
  • tuberculosis preventive therapy
• Source:
  AIDS (London, England), 2026, v. 40, no. 1
• DOI:
  https://doi.org/10.1097/QAD.0000000000004364
• ISSN:
  0269-9370 ; 1473-5571
• Pubmed ID:
  41055970
• Pubmed Central ID:
  PMC12875380
• Document Type:
  Text
• Funding:
  CC999999/ImCDC/Intramural CDC HHSUnited States/
• Genre:
  Journal Article
• Place as Subject:
  Africa South of the Sahara ; United States
• Pages in Document:
  80-89 (18 pdf pages)
• Volume:
  40
• Issue:
  1
• Download URL:
  https://stacks.cdc.gov/view/cdc/261015/cdc_261015_DS1.pdf
• File Type:
  [PDF - 603.32 KB]
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:d8b8032d558f4ef816ddfc02c7a285fc0a8c39d2e9d400ea4984101a23a84242abde6c408300cfae18c5f945bffaacc4cf0d4fadf57b14f223fee9ed2101cc70