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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Clinical presentation and outcome of Tuberculosis in Human Immunodeficiency Virus infected children on anti-retroviral therapy
BMC Pediatrics, Volume 8, Article 1, Year 2008
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Description
Background: The tuberculosis (TB) and human immunodeficiency virus (HIV) epidemics are poorly controlled in sub-Saharan Africa, where highly active antiretroviral treatment (HAART) has become more freely available. Little is known about the clinical presentation and outcome of TB in HIV-infected children on HAART. Methods: We performed a comprehensive file review of all children who commenced HAART at Tygerberg Children's Hospital from January 2003 through December 2005. Results: Data from 290 children were analyzed; 137 TB episodes were recorded in 136 children; 116 episodes occurred before and 21 after HAART initiation; 10 episodes were probably related to immune reconstitution inflammatory syndrome (IRIS). The number of TB cases per 100 patient years were 53.3 during the 9 months prior to HAART initiation, and 6.4 during post HAART follow-up [odds ratio (OR) 16.6; 95% confidence interval (CI) 12.5-22.4]. A positive outcome was achieved in 97/137 (71%) episodes, 6 (4%) cases experienced no improvement, 16 (12%) died and the outcome could not be established in 18 (13%). Mortality was less in children on HAART (1/21; 4.8%) compared to those not on HAART (15/116; 12.9%). Conclusion: We recorded an extremely high incidence of TB among HIV-infected children, especially prior to HAART initiation. Starting HAART at an earlier stage is likely to reduce morbidity and mortality related to TB, particularly in TB-endemic areas. Management frequently deviated from standard guidelines, but outcomes in general were good. © 2008 Walters et al; licensee BioMed Central Ltd.
Authors & Co-Authors
Walters, Elisabetta Ghimenton
South Africa, Cape Town
Stellenbosch University, Faculty of Medicine and Health Sciences
Cotton, Mark Fredric
South Africa, Cape Town
Stellenbosch University, Faculty of Medicine and Health Sciences
Rabie, Helena
South Africa, Cape Town
Stellenbosch University, Faculty of Medicine and Health Sciences
Simon, H.
South Africa, Cape Town
Stellenbosch University, Faculty of Medicine and Health Sciences
Walters, Lourens O.
South Africa, Bloemfontein
Medscheme Holdings
Marais, Ben J.
South Africa, Cape Town
Stellenbosch University, Faculty of Medicine and Health Sciences
Statistics
Citations: 182
Authors: 6
Affiliations: 2
Identifiers
Doi:
10.1186/1471-2431-8-1
e-ISSN:
14712431
Research Areas
Health System And Policy
Infectious Diseases
Maternal And Child Health
Study Design
Cohort Study
Case-Control Study