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Treatment Outcomes of Children with HIV Infection and Drug-Resistant TB in Three Provinces in South Africa, 2005–2008
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12 2017
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Source: Pediatr Infect Dis J. 36(12):e322-e327
Details:
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Alternative Title:Pediatr Infect Dis J
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Personal Author:
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Description:Objective
To describe outcomes of HIV-infected pediatric patients with drug-resistant tuberculosis (DR TB).
Methods
Demographic, clinical, and laboratory data from pediatric patient charts treated for DR TB during 2005–2008 were collected retrospectively from five MDR TB hospitals in South Africa. Data were summarized and Pearson’s chi-squared test or Fisher’s exact test were used to assess differences in variables of interest by HIV status. A time-to-event analysis was conducted using days from start of treatment to death. Variables of interest were first assessed using the Kaplan-Meier method. Cox proportional hazard models were fit to estimate crude and adjusted hazard ratios.
Results
Of 423 eligible participants, 398 (95%) had culture-confirmed DR-TB and 238 (56%) were HIV-infected. A total of 54% were underweight, 42% were male and median age was 10.7 years (IQR: 5.5–15.3). Of the 423 participants, 245 (58%) were successfully treated, 69 (16%) died, treatment failed in 3 (1%), 36 (9%) were lost to follow-up, and 70 (17%) were still on treatment, transferred or had unknown outcomes. Time to death differed by HIV status (p=0.008), sex (p<0.001), year of TB diagnosis (p=0.05) and weight status (p=0.002). Over the two-year risk period, the adjusted rate of death was 2-fold higher among participants with HIV compared to HIV-negative participants (aHR=2.28; 95% CI: 1.11, 4.68).
Conclusions
Male, underweight, and HIV-infected children with DR TB were more likely to experience death when compared to other children with DR TB within this study population.
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Pubmed ID:28746263
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Pubmed Central ID:PMC5797992
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Volume:36
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Issue:12
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