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Volume 26, Number 12—December 2020
CME ACTIVITY - Research

Tuberculosis among Children and Adolescents at HIV Treatment Centers in Sub-Saharan Africa

Anna M. Mandalakas1Comments to Author , Alexander W. Kay1, Jason M. Bacha, Tara Devezin, Rachel Golin, Katherine R. Simon, Dilsher Dhillon, Sandile Dlamini, Andrew DiNardo, Mogo Matshaba, Jill Sanders, Lineo Thahane, Pauline M. Amuge, Saeed Ahmed, Moorine P. Sekadde, Neway G. Fida, Bhekumusa Lukhele, Nodumo Chidah, David Damba, Joseph Mhango, Moses Chodota, Makhorong Matsoso, Angelina Kayabu, Richard S. Wanless, and Gordon E. Schutze
Author affiliations: Texas Children’s Hospital, Houston, Texas, USA (A.M. Manadalakas, A.W. Kay, J.M. Bacha, T. Devezin, K.R. Simon, D. Dhillon, S. Dlamini, A. DiNardo, M. Matshaba, J. Sanders, L. Thahane, S. Ahmed, N. Chidah, D. Damba, M. Chodota, M. Matsoso, A. Kayabu, R.S. Wanless, G.E. Schutze); Baylor College of Medicine, Houston (A.M. Manadalakas, A.W. Kay, J.M. Bacha, T. Devezin, D. Dhillon, A. DiNardo, B. Lukhele, R.S. Wanless, G.E. Schutze); Baylor College of Medicine Children’s Foundation Swaziland, Mbabane, Swaziland (A.W. Kay, S. Dlamini, B. Lukhele); Baylor College of Medicine Children's Foundation Tanzania, Mbeya, Tanzania (J.M. Bacha); US Agency for International Development, Washington, DC, USA (R. Golin); Baylor College of Medicine Children’s Foundation Malawi, Lilongwe, Malawi (K.R. Simon, S. Ahmed, J. Mhango); Technical Support to PEPFAR Programs in the Southern Africa Region, Lilongwe (K.R. Simon, S. Ahmed, J. Mhango); Botswana-Baylor Children’s Clinical Centre of Excellence, Gaborone, Botswana (M. Matshaba, N. Chidah); Baylor College of Medicine Children’s Foundation Lesotho, Maseru, Lesotho (J. Sanders, L. Thahane, M. Matsoso); Baylor College of Medicine Children’s Foundation Uganda, Kampala, Uganda (P.M. Amuge, D. Damba); National Tuberculosis and Leprosy Programme, Kampala, Uganda (M.P. Sekkade); US Agency for International Development, Pretoria, South Africa (N.G. Fida); Baylor College of Medicine Children’s Foundation Tanzania, Mwanza, Tanzania (M. Chodota, A. Kayabu)

Main Article

Table 3

Predictors of favorable TB outcomes against death in HIV-infected children and adolescents, 2013–2017*

Variable
 Odds ratio (95% CI)
 p value
Country
Swaziland, Lesotho, Malawi, Tanzania-Mbeya, Tanzania-Mwanza, and Uganda Referent
Botswana
 0.09 (0.00–22.83)
 0.1811
TB drug resistance
Not tested, multidrug resistance, and not detected Referent
Monoresistance
 18.11 (0.00–31,381.00)
 0.4642
ART category
On ART >6 mos before TB treatment, on ART <6 mos before TB treatment, and on ART >8 wks after TB treatment Referent
Never on ART 3.38 (0.21–20.02) 0.2168
On ART <8 wks after starting TB treatment
 0.41 (0.14–0.60)
 0.0051†
Immune status
Advanced Referent
Not advanced 0.42 (0.13–0.94) 0.0412†
Severe
 1.88 (0.70–4.80)
 0.1233
Each increasing WHO stage 3.64 (2.50–7.17) <0.001‡

*Variables included were sex, COE, site of TB, TB treatment category, TB drug resistance, age at ATT initiation, days in care at COE, immune status, ART TB days, ART category, and World Health Organization stage; all elements under each variable are described in Table 2. Variables excluded were ART regimen pre-ATT initiation, and total ART drugs pre-ATT treatment. ART, antiretroviral therapy; ATT, anti-TB therapy; COE, Center of Excellence; TB, tuberculosis.
†Significant result (p<0.05).
‡Significant result (p<0.01).

Main Article

1These authors contributed equally to this article.

Page created: September 10, 2020
Page updated: December 01, 2020
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