Diagnosis and Treatment of Tuberculosis Among Children at an HIV Care Program in Dar es Salaam, Tanzania

Abstract

Diagnosis and treatment of tuberculosis is challenging in children with HIV infection. We describe the clinical features, diagnostic testing results, tuberculosis and HIV treatment, and clinical outcomes of 57 HIV-infected children diagnosed with tuberculosis at the DarDar Pediatric Program in Dar es Salaam, Tanzania. In this cohort, tuberculosis was common, microbiologic studies were frequently negative and mortality was high.

The burden of vaccine-preventable diseases among HIV-infected and HIV-exposed children in sub-Saharan Africa: a systematic review and meta-analysis

“…Twenty-one TB prevalence studies were pooled together and reported estimated prevalence of 16% (95% CI 12 -19, I 2 = 99%). For studies conducted within the period 1991-2000, the prevalence was 13% (95% CI 8 -18) 40,43 ; lower in 2001-2010 with an estimate of 8% (95% CI 5 -11, I 2 = 96%) 22,33,37,38,51 and recorded the highest prevalence in recent years with 15% (95% CI 8 -22, I 2 = 99) 15,16,18,19,21,23,27,29,31,41,45,46,52,57 (Figure 3). Fourteen prevalence studies on hepatitis B (HBV) infection in HIV-infected children were pooled together with an estimate prevalence of 5% (95% CI 4 -7, I 2 = 90%).…”

“…Twenty-nine studies on TB were pooled to give an overall CFR estimate of 17% (95% CI: 13 -20, I 2 = 95%) which translates to 17% of all TB cases dying from the disease. Subgroup analysis shows the CFR was 18% (95% CI 6 -24) 47 in the 1991-2000 period, 6% (17 -38, I 2 = 95%) 33,[35][36][37]48,49,53,54,56,59 in 2001-2010 and 13% (95% CI 9 -17, I 2 = 96%) 15,16,18,20,[23][24][25]30,34,39,44,46,47,50,55,56 in 2011 -2018. Four studies were pooled for pneumococcal infections CFRs in HIV-infected and exposed children with a resultant rate of 15% (95% CI 4 -26, I 2 = 95%).…”

“…Pneumococcal infections: Incidence of invasive pneumococcal disease among HIV-infected 13 children aged <1 and 1-4 years was 1022 (95% CI 923-1123) per 100,000 and 198 (95% CI 14 178-220) per 100,000 respectively in 2008. 89 The incidence of pneumococcus-associated 15 lower respiratory tract infection among HIV-exposed uninfected children was 109 (95% CI 16 47-214) per 100,000 and 629 (95% CI 130-1838) per 100,000 among HIV-infected children. 86…”