Format

Send to

Choose Destination
See comment in PubMed Commons below
Int J Tuberc Lung Dis. 2014 Apr;18(4):381-7. doi: 10.5588/ijtld.13.0395.

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

Author information

1
Division of Global HIV/AIDS, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA.
2
Ministry of Health, National Programme for Medical Care of Persons Living with HIV/AIDS, Abidjan, Côte d'Ivoire.
3
Division of Global HIV/AIDS, CDC, Abidjan, Côte d'Ivoire.
4
Elizabeth Glaser Pediatric AIDS Foundation, Los Angeles, California, USA.

Abstract

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.

Comment in

PMID:
24670690
DOI:
10.5588/ijtld.13.0395
[Indexed for MEDLINE]
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Ingenta plc
    Loading ...
    Support Center