呼吸器・呼吸器内科

HIV/AIDS Associated Tuberculosis Occurance on Art Initiated Children In North West Ethiopia 2020

Abstract

Fassikaw Kebede*, Tsehay Kebede, Birhanu Kebede, Belete Negese, and Ayinalem Kebede

Background: Tuberculosis (TB) remains the first cause of death from infectious disease worldwide despite available effective therapies. In 2016, there were an estimated 10.4 million new cases of TB,490 000 new cases with multidrug-resistant TB (MDR-TB), and 1.7 million cases died from TB. The aim of this study is to assess HIV/AIDS associated tuberculosis for ART started children in north west Ethiopia 2020

Methods: Hospital based retrospective cohort study was conducted among 421 adult population with HIV/AIDS from to 2009-2018. The Time to develop TB was defined as the time from enrollment for ART care until the development of TB amon on ART. Variables with a 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 was used to identify significant predictor variables to develop TB at P< 0.05.

Results: A total of 421 children were followed up for a total of 662.5 Person Years of Observation (PYO). The median age during ART at enrollment was 8 years (IQR,–2-15). The overall incidence density of tuberculosis in HIV-infected children was 9.6/ 100 PYOs 95%CI: (8.06- 10.3). Tuberculosis occurrence among HIV-infected children was significantly associated with TB history of contact AHR=3.7, 95%CI (2.89-7.2), not started on Cotrimoxazoles (CPT) AHR=2.4, 95%CI (1.84-4.74), incomplete vaccination AHR=2.4, 95%CI (1.32-4.5), severe stunting AHR =2.99:95%CI (1.2-7.81), hemoglobin (Hgb) ≤10 mg/dl AHR = 4.02, 95%CI (2.01-8.1).

Conclusion: More than 80% of TB cases occurred during two years of follow-up after ART initiation. Therefore, intensified CPT screening and therapeutic feeding are highly recommended for all children.