Cavanaugh J., Genga K., Marigu I., Laserson K., Ackers M., Cain K.
Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA 30329, United States; Division of TB Elimination, Centers for Disease Control and Prevention, Atlanta, GA 30329, United States; Division of Leprosy TB and Lung Disease, Ministry of Public Health and Sanitation, Nairobi, 00202, Kenya; Global AIDS Program, Centers for Disease Control and Prevention, Nairobi, 00200, Kenya; Kenya Medical Research Institute, Centers for Disease Control and Prevention, Kisumu, 40100, Kenya; Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA 30333, United States
Cavanaugh, J., Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA 30329, United States, Division of TB Elimination, Centers for Disease Control and Prevention, Atlanta, GA 30329, United States; Genga, K., Division of Leprosy TB and Lung Disease, Ministry of Public Health and Sanitation, Nairobi, 00202, Kenya; Marigu, I., Global AIDS Program, Centers for Disease Control and Prevention, Nairobi, 00200, Kenya; Laserson, K., Kenya Medical Research Institute, Centers for Disease Control and Prevention, Kisumu, 40100, Kenya, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA 30333, United States; Ackers, M., Global AIDS Program, Centers for Disease Control and Prevention, Nairobi, 00200, Kenya; Cain, K., Division of TB Elimination, Centers for Disease Control and Prevention, Atlanta, GA 30329, United States
We collected clinical register data on children in two provinces of Kenya and conducted bivariate and multivariate analyses to assess characteristics associated with death. Among 987 children with tuberculosis (TB), pulmonary disease was diagnosed in 689 (70%) children. Final outcomes were known for 830 children, 40 (5%) of whom died during TB treatment. HIV test results were available for 670 (68%) children; 371 (55%) of whom tested positive. Only 63 of 134 (47%) of children <1 year were tested for HIV. There were no data on CD4 or anti-retroviral use. The relative risk for death for HIV-infected children compared to HIV-uninfected children was 9.3 for children <1 year [95% confidence interval (CI) 1.2-69.2], 3.9 for children aged 1-4 (95% CI 0.9-17.7) and 0.9 for children aged 5-14 (95% CI 0.3-2.6). In Kenya, HIV infection in children with TB is common, and our data suggest that HIV is particularly deadly in TB patients <1 year, the group with the lowest rate of testing. Poor data recording and reporting limit our understanding of TB in this age group. Expansion of HIV testing may improve survival, and more complete data recording and reporting will enhance our understanding of pediatric TB. Published by Oxford University Press 2011.
antiretrovirus agent; tuberculostatic agent; adolescent; adult; article; bivariate analysis; child; childhood disease; clinical assessment; controlled study; epidemiology; female; highly active antiretroviral therapy; HIV test; human; Human immunodeficiency virus infection; infant; Kenya; lung disease; lung tuberculosis; major clinical study; male; mortality; multivariate analysis; preschool child; register; school child; tuberculosis; Adolescent; Age Distribution; AIDS-Related Opportunistic Infections; Antitubercular Agents; Child; Child, Preschool; Confidence Intervals; Female; HIV Infections; Humans; Infant; Kenya; Male; Multivariate Analysis; Retrospective Studies; Risk Factors; Treatment Outcome; Tuberculosis, Pulmonary