Tuberculosis in human immunodeficiency virus-infected children starting antiretroviral therapy in Côte d’Ivoire

Details

• Alternative Title:
  Int J Tuberc Lung Dis
• Personal Author:
  Auld, A. F. ; Tuho, M. Z. ; Ekra, K. A. ; Kouakou, J. ; Shiraishi, R. W. ; Adjorlolo-Johnson, G. ; Marlink, R. ; Ellerbrock, T. V.
• Description:
  SETTING:
  
  In Côte d’Ivoire, more than 2000 human immunodeficiency virus (HIV) infected children aged <15 years were started on antiretroviral therapy (ART) during 2004–2008.
  
  OBJECTIVES:
  
  To estimate tuberculosis (TB) incidence and determinants among ART enrollees.
  
  DESIGN:
  
  A nationally representative retrospective cohort study among 2110 children starting ART during 2004–2008 at 29 facilities.
  
  RESULTS:
  
  At ART initiation, the median age was 5.1 years; 82% had World Health Organization Stage III/IV, median CD4% was 11%, 42% were severely undernourished (weight-for-age Z-score [WAZ] <−3), and 150 (7%) were taking anti-tuberculosis treatment. Documentation of TB screening before ART declined from 63% to 46% during 2004–2008. Children taking anti-tuberculosis treatment at ART enrollment had a lower median CD4% (9.0% vs. 11.0%, P = 0.037) and a higher prevalence of WAZ <−3 (59% vs. 40%, P < 0.001). Among children considered TB-free at ART enrollment, TB incidence was 6.28/100 child-years during days 0–90 of ART, declining to 0.56/100 child-years after 180 days. Children with one unit higher WAZ at ART enrollment had 13% lower TB incidence (adjusted HR 0.87, 95%CI 0.77–1.00, P = 0.047).
  
  CONCLUSIONS:
  
  Ensuring clinician compliance with TB screening before ART and ensuring earlier ART initiation before children suffer from advanced HIV disease and nutritional compromise might reduce TB morbidity during ART.
  
  
• Subjects:
  Adolescent Age Factors Anti-HIV Agents Antitubercular Agents CD4 Lymphocyte Count Child Child, Preschool Child Nutrition Disorders Coinfection Cote D'Ivoire Female HIV Infections Humans Incidence Male Mass Screening Nutritional Status Predictive Value Of Tests Prevalence Retrospective Studies Time Factors Tuberculosis

  More +
• Keywords:
  Incident Tuberculosis Ivory Coast Pediatric Tuberculosis Screening
• Source:
  Int J Tuberc Lung Dis. 18(4):381-387
• Pubmed ID:
  24670690
• Pubmed Central ID:
  PMC7430030
• Document Type:
  Journal Article
• Funding:
  CC999999/Intramural CDC HHSUnited States/
• Volume:
  18
• Issue:
  4
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:f0023a4d5b9371780d7049999aae404f6c95b10a6a2918c2b9ba4675bdd6aa3c
• Download URL:
  https://stacks.cdc.gov/view/cdc/92145/cdc_92145_DS1.pdf
• File Type:
  [PDF - 770.90 KB ]