Magnitude of tuberculosis and its associated factors among under-five children admitted with severe acute malnutrition to public hospitals in the city of Dire Dawa, Eastern Ethiopia, 2021: multi-center cross-sectional study

Atalell, Kendalem Asmare; Haile, Ribka Nigatu; Techane, Masresha Asmare

doi:10.1016/j.ijregi.2022.04.008

Cited by 3 publications

(5 citation statements)

References 16 publications

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“…This makes it di cult for the body to contain the mycobacterium tuberculosis organisms resulting in clinical tuberculosis. This was in agreement with two studies in Ethiopia where HIV infection increased odds of having TB (13,29).…”

Section: Discussionsupporting

confidence: 93%

“…Our prevalence was higher than that reported in India (13%) (16), in Nepal (4.67%) (17), in Ethiopia (10.39%) (13) and in Congo (8.4%) (18), but slightly lower than that reported in South Africa (25.6%) (19). The differences in the prevalence of tuberculosis can be attributed to the study population differences since the burden of tuberculosis varies geographically, but also the criteria used for diagnosis of tuberculosis in these studies.…”

Section: Discussioncontrasting

confidence: 79%

“…HIV infection attacks the white blood cells resulting in the impairment of the child's immune system (29). This impairment in the immune system is even made worse by the presence of malnutrition in these children (13). This makes it di cult for the body to contain the mycobacterium tuberculosis organisms resulting in clinical tuberculosis.…”

Section: Discussionmentioning

confidence: 99%

“…The sample size was determined using the Epi-info online sample size calculator (12). Considering a history of contact with a TB patient increasing the odds of TB by 3.58 among patients with SAM in Eastern, Ethiopia (13), with a power of 80% and 95% level of con dence, considering the percent of unexposed with outcome to be 15 according to (13), the sample size required was 124. Adding 10% to cater for non-respondents, the sample size required was 137 study participants.Participants were consecutively enrolled until the desired sample size was achieved.…”

Section: Study Populationmentioning

confidence: 99%

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Prevalence, radio-clinical patterns and factors associated with pulmonary tuberculosis among children with severe acute malnutrition: A crossectional study in Uganda

Asiimwe,

Ndezi,

Nduwimana

et al. 2024

Preprint

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Background Although treatable, pulmonary tuberculosis (PTB) has a significant morbidity and mortality. Children with malnutrition are immune compromised, which increases the morbidity and mortality of PTB. This study was done to determine the prevalence and factors associated with Tuberculosis among children aged 6 to 59 months admitted with severe acute malnutrition (SAM) at Jinja Regional Referral Hospital (JRRH). Methods This was a cross–sectional study among children aged 6-59 months with SAM at JRRH. History was taken and physical examination done. Gene Xpert was done for all participants, Lipoarabinomannan Antigen Assay for TB (TB-LAM) done for HIV positive children with CD4 below 200 and Chest X-ray for children who presented with cough and difficulty in breathing. Both the investigations and clinical findings were used to make a diagnosis of PTB. Using binary logistic regression in SPSS, the factors associated with Tuberculosis were determined. P value <0.05 was considered significant. Results Of the 137 children enrolled with SAM, majority were in the age groups of 6-11 and 12-23 months. Non-edematous malnutrition was the commonest 73(53.3%). Thirty-two children were diagnosed with TB with a prevalence of 23.4%. Of the 32 diagnosed with Tuberculosis, only 5 had a positive gene expert test, 2 had a positive urine TB LAM and the remaining 25 were diagnosed using the clinical criteria. The commonest symptoms among children diagnosed with TB were cough seen in 25/32 (78.1%) and fever in 24/32 (75%). The most common radiological findings comprised adenopathy (64.3%) and consolidations (49.7%). Coming from rural areas (aOR=1.205, 95%CI=1.067-1.360, P=0.003), being HIV positive (aOR=1.619, CI=1.114-2.354, P=0.012), thrombocytopenia (aOR=1.407, CI=1.069-1.853, P=0.015) and thrombocytosis (aOR=1.202, CI=1.047-1.379, P=0.009) were independently associated with presence of Tuberculosis. Conclusion The prevalence of tuberculosis in Severe Acute Malnutrition was high. Children with SAM should be routinely screened for TB. When resources are constrained, the iinvestigations for TB could be focused on those coming from rural areas, the HIV positive, those with thrombocytopenia and those with thrombocytosis.

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Section: Discussionsupporting

confidence: 93%

Section: Discussioncontrasting

confidence: 79%

Section: Discussionmentioning

confidence: 99%

Section: Study Populationmentioning

confidence: 99%

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Prevalence, radio-clinical patterns and factors associated with pulmonary tuberculosis among children with severe acute malnutrition: A crossectional study in Uganda

Asiimwe,

Ndezi,

Nduwimana

et al. 2024

Preprint

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“…7 The prevalence of TB in under 5 years old children’s diagnosed with SAM was 10.39% in a study done in Ethiopia. 8 …”

Section: Introductionmentioning

confidence: 99%

Survival Status and Predictors of Tuberculosis Development Among Under 5 Children Admitted With Severe Acute Malnutrition in Ethiopia: A Retrospective Cohort Study

Wake

2024

Global Pediatric Health

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Introduction. The burden of severe acute malnutrition (SAM) remains unacceptably high worldwide. The burden of Tuberculosis (TB) co-occurring with SAM in under 5 children is a significant focus for the improvement of child health. The co-existence of these diseases are significantly enhancing the associated morbidity, mortality, and hospitalization costs among this population. Objective. To determine survival status and predictors of TB development in under 5 children with SAM in Asella Referral and Teaching Hospital, Ethiopia. Methods. A retrospective cohort study was done in 247 under 5 children with SAM between January 01/2018 and December 31/2022. Systematic sampling technique was used to select the study participants. Data extraction format was used to collect data from the patient’s medical chart. EpiData version 4.6.0.6 was used for data entry and exported to STATA version 14.2 for statistical analysis. Result. This study includes 247 under 5 children with SAM with a response rate of 100%. Regarding to the survival status; 24(17%) of under 5 children with SAM have developed the events (TB) and the rest of them, 205(83%) were censored. The incidence density rate (IDR) of TB in under 5 children with SAM was 45.51 per 100 (95% CI: 33.63, 61.58) children-months observation. The cumulative incidence of TB was 17% (95% CI: 12.79, 22.25). Multivariable Cox proportional hazard analysis revealed that: having a history of TB contact (AHR = 5.56, 95% CI: 2.77, 11.15, P-value = .000), having a history of bottle feeding (AHR = 4.95, 95%CI: 1.08, 22.77, P-value = .040), did not take F100 (AHR = 1.71, 95% CI: 1.12, 7.25, P-value = .00) were statistically significant predictors of TB development. Conclusion. This study shows that the IDR of TB was high. Having a history of TB contact, history of bottle feeding, and not taking F100 were significant predictors of TB development. It is vital to address these predictors to prevent the development of TB in this population. Moreover, early screening of TB in these children should get high emphasize.

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The Spectrum of Pathogens Associated with Infections in African Children with Severe Acute Malnutrition: A Scoping Review

Ekeng,

Adedokun,

Otu

et al. 2024

TropicalMed

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Understanding the interplay between infections and severe acute malnutrition is critical in attaining good clinical outcomes when managing malnourished children. However, review studies describing the profile of the associated pathogens in the malnourished African paediatric population are sparse in the literature. We aimed to identify the spectrum of pathogens from studies reporting infections in severely malnourished African children, as well as the antibiotic resistance pattern and clinical outcomes. A systematic literature review of the PubMed database was conducted following PRISMA guidelines from January 2001 to June 2024. The search algorithm was ((marasmus) OR (kwashiorkor) OR (severe acute malnutrition) OR (protein energy malnutrition)) AND (Africa). For a more comprehensive retrieval, an additional search algorithm was deployed: ((HIV) OR (tuberculosis)) AND (severe acute malnutrition). We included 60 studies conducted between 2001 and 2024. Most of the studies were from East Africa (n = 45, 75%) and Southern Africa (n = 5, 8.3%). A total of 5845 pathogens were identified comprising 2007 viruses, 2275 bacteria, 1444 parasites, and 119 fungal pathogens. The predominant pathogens were HIV, Mycobacterium tuberculosis, and malaria parasites accounting for 33.8%, 30%, and 24.2% of pathogens identified. Antibiotic susceptibility testing was documented in only three studies. Fatality rates were reported in 45 studies and ranged from 2% to 56% regardless of the category of pathogen. This review affirms the deleterious effect of infections in malnourished patients and suggests a gross underdiagnosis as studies were found from only 17 (31.5%) African countries. Moreover, data on fungal infections in severely malnourished African children were nearly absent despite this population being at risk. Thus, there is an urgent need to prioritize research investigating African children with severe acute malnutrition for fungal infections besides other pathogens and improve the availability of diagnostic tools and the optimized usage of antibiotics through the implementation of antimicrobial stewardship programmes.

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Magnitude of tuberculosis and its associated factors among under-five children admitted with severe acute malnutrition to public hospitals in the city of Dire Dawa, Eastern Ethiopia, 2021: multi-center cross-sectional study

Cited by 3 publications

References 16 publications

Prevalence, radio-clinical patterns and factors associated with pulmonary tuberculosis among children with severe acute malnutrition: A crossectional study in Uganda

Prevalence, radio-clinical patterns and factors associated with pulmonary tuberculosis among children with severe acute malnutrition: A crossectional study in Uganda

Survival Status and Predictors of Tuberculosis Development Among Under 5 Children Admitted With Severe Acute Malnutrition in Ethiopia: A Retrospective Cohort Study

The Spectrum of Pathogens Associated with Infections in African Children with Severe Acute Malnutrition: A Scoping Review

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