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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Impact of expanded antiretroviral use on incidence and prevalence of tuberculosis in children with HIV in Kenya
International Journal of Tuberculosis and Lung Disease, Volume 17, No. 10, Year 2013
Notification
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Description
SETTING: Antiretroviral therapy (ART) reduces pulmonary tuberculosis (PTB) in human immunodeficiency virus (HIV) infected children. Recent ART recommendations have increased the number of children on ART. OBJECTIVE: To determine the prevalence and incidence of TB in HIV-infected children after the implementation of expanded ART guidelines. DESIGN: A prospective cohort study including HIVinfected children aged 6 weeks to 14 years was conducted in Kenya. The primary outcome measure was clinically diagnosed TB. Study participants were screened for prevalent TB at enrollment using Kenya's national guidelines and followed at monthly intervals to detect incident TB. Predictors of TB were assessed using logistic regression and Cox proportional hazards regression. RESULTS: Of 689 participants (median age 6.4 years), 509 (73.9%) were on ART at baseline. There were 51 cases of prevalent TB (7.4%) and 10 incident cases, with over 720.3 child-years of observation (incidence 1.4 per 100 child-years). Months on ART (adjusted hazard ratio [aHR] 0.91, P = 0.003; aOR 0.91, P < 0.001) and months in care before ART (aHR 0.87, P = 0.001; aOR 0.92, P < 0.001) were protective against incident and prevalent TB. CONCLUSIONS: ART was protective against TB in this cohort of HIV-infected children with high levels of ART use. Optimal TB prevention strategies should emphasize early ART in children. © 2013 The Union.
Authors & Co-Authors
Abuogi, Lisa L.
United States, San Francisco
University of California, San Francisco
Kenya, Nairobi
Family Aids Care and Education Services
Mwachari, Christina W.
Kenya, Nairobi
Family Aids Care and Education Services
Kenya, Nairobi
Respiratory Diseases Research Centre
Leslie, Hannah H.
United States, San Francisco
Ucsf School of Medicine
Shade, Starley B.
United States, San Francisco
Ucsf School of Medicine
Otieno, James Richard
Kenya, Kisumu
New Nyanza Provincial General Hospital
Yienya, N.
Kenya, Nairobi
Family Aids Care and Education Services
Sanguli, L.
Kenya, Nairobi
Family Aids Care and Education Services
Kenya, Nairobi
Respiratory Diseases Research Centre
Amukoye, Evans Inyangala
Kenya, Nairobi
Respiratory Diseases Research Centre
Cohen, Craig R.
Kenya, Nairobi
Family Aids Care and Education Services
United States, San Francisco
University of California, San Francisco
Statistics
Citations: 27
Authors: 9
Affiliations: 5
Identifiers
Doi:
10.5588/ijtld.12.0740
ISSN:
10273719
Research Areas
Environmental
Infectious Diseases
Maternal And Child Health
Study Design
Cross Sectional Study
Cohort Study
Study Approach
Quantitative
Study Locations
Kenya