Pulmonary Tuberculosis in Children with HIV Infection: From Symptoms to Diagnosis and Treatment in a Pediatric Center in Yaoundé-Cameroon

Félicitée, Nguefack; Ntoto, Njiki Kinkela Mina; Dongmo, Roger; Chelo, David; Flora, Neh; Olivier, Koki Ndombo Paul

doi:10.21767/2471-9676.100011

Cited by 4 publications

(7 citation statements)

References 24 publications

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“…The source population for this study were all HIVinfected children (aged < 15 years) ever initiated on Pawe and Assosa general hospitals , with the study population including those HIV- 2) For incomplete data =10% 3) Event = (Z a/2+ ZB ) 2 = 251 by substitution each parameter into formula π1 π2 (log AHR) 2 P (event) = 1-(π1 S1 (t) + π2S2 (t)) freedman principles [24] H0: S1 (t) = S2 (t), for all t 4) P (event) = 1-0.…”

Section: Source and Study Participantsmentioning

confidence: 99%

“…Pulmonary tuberculosis (TB) is one of the comrade causes of morbidity and mortality with human immunodeficiency virus (HIV) for HIV-infected children [1]. Its dual co-infection with HIV for children less than 15 years is an emerging global concern [2,3].Depletions of immunity by rapid viral reproduction increase the susceptibility for progressions of reactivations of latent mycobacterium to active TB infection [1] . Study results on HIV infected children indicated the incidence of PTB as co-infection provokes sputum conversion period by remaining extensive cavitation lesion in the lung [4].This made a delay of standard treatment outcome [2,5] .Currently, the incidence of pulmonary tuberculosis among HIV-infected children is high in twines TB-HIV epidemic countries 830 -17,500/ 100 000 P-Y[6].…”

Section: Introductionmentioning

confidence: 99%

“…. Different study result among HIV infected children indicated that factors contribute for PTB incidence were identified WHO clinical stage3&4 [10],residence [2],not started isoniazid [11]. Global TB report of 2018 indicated ,Ethiopia found top 17 TB&HIV twine epidemic country [3].…”

Section: Introductionmentioning

confidence: 99%

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Time to Develop Pulmonary Tuberculosis and Predictors Among HIV Infected Children Receiving Anti-Retroviral Therapy in Assosa and Pawe General Hospitals, North West Ethiopia 2020

bizuneh¹,

Boneya²,

Dessie³

2020

Preprint

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Recently, pulmonary tuberculosis (PTB) incidence is a serious co-infection and an emerging global concern for children living with human immune deficiency virus (HIV). However, the incidence of PTB among adult HIV patients is exhaustively studied; the incidence of PTB among children on ART is overlooked. This research provides invaluable time based relevant actionsclues.Objective:- Hospital-based retrospective cohort study was conducted among 359 HIV infected children those registered on ART since 2009-2018. Time to develop PTB defined as the time from enrollment for ART care until the development of PTB. The proportional hazard assumption was checked for each variable and no variable was found with Schoenfeld test <0.05. Variables with P-value <0.25 at bivariate Cox regression analysis were entered into the multivariable Cox model. Multivariable Cox regression model with 95%CI and AHR used to identify significant predictor. Result:-Totally 359 HIV infected children followed and produced 686.5 Person per Years of observation (PYOs) with minimum and maximum follow up time on ART was 0.34 & 5.1 years, respectively. The median age of the children was 9 (SD±3.78) years. The overall incidence density of PTB was 7.2 Person/100years in 95%CI (5.52--- 9.24).Notably being age group >= 11 years (AHR=5.1 95% CI 1.4--18.), who stage 3&4 (AHR= 3.4 times increase the risks of PTB developed was compared WHO clinical stage 1& 2 (AHR=3.4 95%CI: 1.2-9.7). Being sever underweight (AHR=3.2 95%CI: 1.3--7.8), not started INHAHR =2.8, 95%CI: 1.1 -7.2) and having previous opportunistic infections (AHR= 2.34 95%CI: 1.3--4.1) significantly associated with PTB incidence. Conclusion:-The incidence of PTB in HIV infected children were found higher as compared with evidence from previous findings. Strengthening intensified screening of INH and therapeutic feeding needs for risk children highly recommended.

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Section: Source and Study Participantsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Time to Develop Pulmonary Tuberculosis and Predictors Among HIV Infected Children Receiving Anti-Retroviral Therapy in Assosa and Pawe General Hospitals, North West Ethiopia 2020

bizuneh¹,

Boneya²,

Dessie³

2020

Preprint

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“…[5][6][7][8] Data describing delays and barriers to early TB treatment initiation in children are limited. [9][10][11][12][13] A study by Beyers et al reported 4 weeks of TB diagnostic delay. 9 The recent Indian study documented 41 days of health system delay.…”

Section: Introductionmentioning

confidence: 99%

“…10 Studies related to children with HIV-TB reported longer delays. 11,12 A systematic review on barriers to delays in children and youth documented only four pediatric cohort studies. 13 The above literature lacked in-depth analysis of pathway of care to treatment initiation in childhood TB.…”

Section: Introductionmentioning

confidence: 99%

Delays and barriers to early treatment initiation for childhood tuberculosis in India

Valvi

Chandanwale

Khadse

et al. 2019

int j tuberc lung dis

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BACKGROUND: India accounts for 27% of global childhood tuberculosis (TB) burden. Understanding barriers to early diagnosis and treatment in children may improve care and outcomes.METHODS: A cross-sectional study was performed among 89 children initiated on anti-TB treatment from a public hospital in Pune during 2016, using a structured questionnaire and hospital records. Health care providers (HCPs) were defined as medical personnel consulted about the child's TB symptoms. Time-to-treatment initiation (TTI) was defined as the number of days between onset of TB symptoms and anti-TB treatment initiation. Based on Revised National TB Control Programme recommendations, delayed TTI was defined as >28 days.RESULTS: Sixty-seven (75%) of 89 enrolled children had significant TTI delays (median 51 days, interquartile range [IQR] 27–86). Sixty-six (74%) children visited 1–8 HCPs in the private sector before approaching the public sector. The median HCP delay was 28 days (IQR 10–75). Bacille Calmette-Guérin vaccination (aOR 10.96, P = 0.04) and loss of appetite (aOR 4.44, P = 0.04) were associated with delayed TTI.CONCLUSION: The majority of the children had TTI delays due to delays by HCPs in the private sector. Strengthening HCP competency in TB symptom screening and encouraging early referrals are crucial for rapid scaling up of early treatment initiation in childhood TB.

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Prevalence of culture positive Tuberculosis and utility of a clinical diagnostic tool for the diagnosis of Tuberculosis among HIV Infected Children attending HIV/AIDS Care and Treatment in Dodoma Municipality, Central Tanzania

Mutabazi

Jumanne

Mpondo

et al. 2020

International Journal of Infectious Diseases

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To evaluate the performance of the modified Keith Edwards TB clinical diagnostic tool among HIV infected children. Methods: Cross sectional study of 252 HIV infected children < 15 years old suspected with TB at four HIV/AIDS Care Clinics in Dodoma, Tanzania from November 2018 -March 2019. The modified Keith Edwards TB clinical diagnostic tool was compared to gastric aspirates, lymphnode aspirates or sputum gene x-pert MTB/RIF and TB culture. Sensitivity, specificity, negative and positive predictive value of the clinical tool were determined. Data was analyzed using SPSS version 25. Results: Out of 252 children evaluated, 13.5% (34/252) had TB using the clinical diagnostic tool and 5.2% (13/252) had culture positive TB. The sensitivity of the clinical tool was 76.9%, specificity of 90%. Culture positive TB predictors were lymphadenopathy (AOR 13.74,) p value < 0.001), weight loss (AOR 3.19,95%CI (1.38 -7.36) p value 0.007), and difficulty breathing (AOR 7.25,) p value 0.012). Conclusion:The utility of the modified Keith Edwards clinical diagnostic tool for Tuberculosis diagnosis among HIV infected children is limited, calling for further validation. HIV infected children with lymphadenopathy, failure to thrive and difficulty in breathing are at high risk of Tuberculosis.

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Pulmonary Tuberculosis in Children with HIV Infection: From Symptoms to Diagnosis and Treatment in a Pediatric Center in Yaoundé-Cameroon

Cited by 4 publications

References 24 publications

Time to Develop Pulmonary Tuberculosis and Predictors Among HIV Infected Children Receiving Anti-Retroviral Therapy in Assosa and Pawe General Hospitals, North West Ethiopia 2020

Time to Develop Pulmonary Tuberculosis and Predictors Among HIV Infected Children Receiving Anti-Retroviral Therapy in Assosa and Pawe General Hospitals, North West Ethiopia 2020

Delays and barriers to early treatment initiation for childhood tuberculosis in India

Prevalence of culture positive Tuberculosis and utility of a clinical diagnostic tool for the diagnosis of Tuberculosis among HIV Infected Children attending HIV/AIDS Care and Treatment in Dodoma Municipality, Central Tanzania

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Pulmonary Tuberculosis in Children with HIV Infection: From Symptoms to Diagnosis and Treatment in a Pediatric Center in Yaoundé-Cameroon

Cited by 4 publications

References 24 publications

Time to Develop&nbsp;Pulmonary Tuberculosis&nbsp;and Predictors&nbsp;Among HIV Infected Children Receiving Anti-Retroviral Therapy&nbsp;in&nbsp;Assosa and&nbsp;Pawe General Hospitals, North West Ethiopia 2020

Time to Develop&nbsp;Pulmonary Tuberculosis&nbsp;and Predictors&nbsp;Among HIV Infected Children Receiving Anti-Retroviral Therapy&nbsp;in&nbsp;Assosa and&nbsp;Pawe General Hospitals, North West Ethiopia 2020

Delays and barriers to early treatment initiation for childhood tuberculosis in India

Prevalence of culture positive Tuberculosis and utility of a clinical diagnostic tool for the diagnosis of Tuberculosis among HIV Infected Children attending HIV/AIDS Care and Treatment in Dodoma Municipality, Central Tanzania

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Time to Develop Pulmonary Tuberculosis and Predictors Among HIV Infected Children Receiving Anti-Retroviral Therapy in Assosa and Pawe General Hospitals, North West Ethiopia 2020

Time to Develop Pulmonary Tuberculosis and Predictors Among HIV Infected Children Receiving Anti-Retroviral Therapy in Assosa and Pawe General Hospitals, North West Ethiopia 2020