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Germs. 2016 Mar 1;6(1):21-8. doi: 10.11599/germs.2016.1085. eCollection 2016.

Prevalence of and risk factors for pulmonary tuberculosis among newly diagnosed HIV-1 infected Nigerian children.

Author information

  • 1MBBS, MSc, Department of Pediatrics, University of Jos, Jos University Teaching Hospital, Jos, Nigeria.
  • 2BM. Bch, Department of Pediatrics, University of Jos, Jos University Teaching Hospital, Jos, Nigeria.
  • 3MBBS, Department of Pediatrics, University of Jos, Jos University Teaching Hospital, Jos, Nigeria.
  • 4MBBS, Department of Medicine, University of Jos, Jos University Teaching Hospital, Jos, Nigeria.
  • 5BPharm, MSc, Pharmacy Department, Jos University Teaching Hospital, Jos, Nigeria.
  • 6BSc, MBChB, Department of Obstetrics and Gynecology, University of Jos/ Jos University Teaching Hospital, Jos, Nigeria.
  • 7BSc, MSc, AIDS Prevention Initiative in Nigeria (APIN), Jos University Teaching Hospital, Jos, Nigeria.
  • 8MBBS, AIDS Prevention Initiative in Nigeria (APIN) Ltd. Gte, Abuja, Nigeria.
  • 9MBBS, National Agency for the Control of AIDS (NACA), Abuja, Nigeria.
  • 10DVM, SD, Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, MA, USA.

Abstract

INTRODUCTION:

Studies on the prevalence of and risk factors for tuberculosis (TB) among newly diagnosed human immunodeficiency virus (HIV)-infected children in sub-Saharan Africa are scarce and in Nigeria there is paucity of reported data. We determined the prevalence of and risk factors for pulmonary TB (PTB) in newly diagnosed (treatment-naïve) HIV-1 infected children at the pediatric HIV clinic of the Jos University Teaching Hospital (JUTH) in Nigeria.

METHODS:

We performed a retrospective analysis of 876 children, aged 2 months - 13 years, diagnosed with HIV-1 infection between July 2005 and December 2012, of which 286 were diagnosed with PTB at presentation after TB screening. The study site was the AIDS Prevention Initiative in Nigeria (APIN)-supported Pediatric HIV clinic at JUTH, Jos. A multivariate forward logistic regression modelling was used to identify risk factors for PTB-HIV co-infection.

RESULTS:

The prevalence of PTB-HIV co-infection was 32% (286/876). Severe immunosuppression (SI) and World Health Organization (WHO) HIV clinical stage 3/4 were identified as independent risk factors for PTB-HIV co-infection in HIV infected children. The odds of PTB-HIV co-infection was increased two-fold in HIV-infected children with WHO clinical stage 3/4 compared to those with stage 1/2 (adjusted odds ratio (AOR) 1.76 [1.31-2.37], p<0.001) and 1.5-fold in children with SI compared to those without SI (AOR 1.52 [1.12-2.06], p=0.007).

CONCLUSION:

In our setting, the burden of PTB was high among newly diagnosed HIV-infected children, and late WHO HIV clinical stage and severe immunosuppression were associated with PTB-HIV co-infection. Therefore there is a clear need to improve strategies for early diagnosis of both HIV and PTB to optimize clinical outcomes.

KEYWORDS:

HIV-1; PTB; WHO HIV clinical stage; children; co-infection; severe immunosuppression

PMID:
27019829
PMCID:
PMC4788778
DOI:
10.11599/germs.2016.1085
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