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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Tuberculosis in human immunodeficiency virus-infected children starting antiretroviral therapy in Côte d'Ivoire
International Journal of Tuberculosis and Lung Disease, Volume 18, No. 4, Year 2014
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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 antituberculosis 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. © 2014 The Union.
Authors & Co-Authors
Auld, Andrew F.
United States, Atlanta
National Center for Hiv, Viral Hepatitis, Std, and tb Prevention
Tuho, Moïse
Cote D'ivoire, Abidjan
National Programme for Medical Care of Persons Living with Hiv/aids
Ekra, K. Alexandre
United States, Atlanta
Centers for Disease Control and Prevention
Kouakou, Joseph S.
United States, Atlanta
Centers for Disease Control and Prevention
Shiraishi, Ray W.
United States, Atlanta
National Center for Hiv, Viral Hepatitis, Std, and tb Prevention
Adjorlolo-Johnson, Georgette T.
United States, Washington, D.c.
Elizabeth Glaser Pediatric Aids Foundation
Marlink, Richard G.
United States, Washington, D.c.
Elizabeth Glaser Pediatric Aids Foundation
Ellerbrock, Tedd V.
United States, Atlanta
National Center for Hiv, Viral Hepatitis, Std, and tb Prevention
Statistics
Citations: 16
Authors: 8
Affiliations: 4
Identifiers
Doi:
10.5588/ijtld.13.0395
ISSN:
10273719
Research Areas
Infectious Diseases
Maternal And Child Health
Study Design
Cross Sectional Study
Cohort Study
Study Approach
Quantitative
Study Locations
Ivory Coast