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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Malnutrition associated with unfavorable outcome and death among South African MDR-TB and HIV co-infected children
International Journal of Tuberculosis and Lung Disease, Volume 18, No. 9, Year 2014
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Description
SETTING: Pediatric multidrug-resistant tuberculosis (MDR-TB) is complicated by difficult diagnosis, complex treatment, and high mortality. In South Africa, these challenges are amplified by human immunodeficiency virus (HIV) co-infection; however, evidence on treatment outcomes among co-infected children is limited. OBJECTIVE: Using conventional and new pediatric definitions, to describe treatment outcomes and identify risk factors for unfavorable outcome and mortality in children aged <15 years with MDR-TB or extensively drug-resistant TB (XDR-TB) in KwaZulu-Natal, South Africa. DESIGN: Retrospective cohort study in a regional TB referral hospital. RESULTS: From January 2009 to June 2010, 84 children (median age 8 years, IQR 4-12) with MDR-TB (n = 78) or XDR-TB (n = 6) initiated treatment. Sixty-four (77%) were HIV-positive and 62 (97%) received antiretroviral therapy. Sixty-six (79%) achieved favorable treatment outcomes. Overall mortality was 11% (n = 9) at 18 months after initiation of treatment. Malnutrition (aOR 27.4, 95%CI 2.7-278.7) and severe radiographic findings (aOR 4.68, 95%CI 1.01-21.9) were associated with unfavorable outcome. New pediatric outcome definitions increased the proportion classified as cured. CONCLUSION: It is possible to successfully treat pediatric MDR-TB-HIV even in resource-poor settings. Malnutrition is a marker for severe TB-HIV disease, and is a potential target for future interventions in these patients. © 2014 The Union.
Authors & Co-Authors
Hicks, R. M.
United States, New York
Albert Einstein College of Medicine of Yeshiva University
South Africa, Congella
Centre for the Aids Programme of Research in South Africa
Padayatchi, Nesri
South Africa, Congella
Centre for the Aids Programme of Research in South Africa
Shah, Neha Sarita
United States, New York
Albert Einstein College of Medicine of Yeshiva University
Wolf, Allison K.
United States, New York
Albert Einstein College of Medicine of Yeshiva University
Werner, Lise
South Africa, Congella
Centre for the Aids Programme of Research in South Africa
Sunkari, V. B.
South Africa, Durban
King Dinuzulu Hospital
O'Donnell, Max R.
United States, New York
Albert Einstein College of Medicine of Yeshiva University
South Africa, Congella
Centre for the Aids Programme of Research in South Africa
Statistics
Citations: 65
Authors: 7
Affiliations: 3
Identifiers
Doi:
10.5588/ijtld.14.0231
ISSN:
10273719
Research Areas
Food Security
Health System And Policy
Infectious Diseases
Maternal And Child Health
Study Design
Cohort Study
Study Approach
Quantitative
Study Locations
South Africa