Tuberculosis (TB) is the leading cause of death in human immunodeficiency virus (HIV)-positive children worldwide. However, predictors of mortality in pediatric patients with TB/HIV are unclear, according to a study published in Archives of Public Health.

Researchers examined co-infected children attending antiretroviral therapy (ART) clinics at public hospitals in Ethiopia and found that anemia, drug-resistant TB, extrapulmonary TB, and poor adherence to ART drugs were predictors of mortality.

Furthermore, Jifare Gemechu, lead author, reported that the mortality rate of the included patients with TB/HIV was 2.78 per child years of observation.

The retrospective study included 284 TB/HIV co-infected subjects. Kaplan Meier curves and log rank tests were used to examine survival, and variable analyses were used to identify the mortality predictors.

Among the 284 participants, 35 (12.3%) died during the study period. As noted, the morality rate per 100 child years of observation was 2.78 (95% confidence interval [CI], 1.98–3.99).  The adjusted hazard ratios for the predictors of mortality were: 3.6 for anemia (95% CI, 1.39–9.31); 2.9 for fair or poor ART adherence (95% CI, 1.15–7.43); 3.9 for extrapulmonary TB (95% CI, 1.34–11.45); and 5.7 for drug-resistant TB (95% CI, 2.07–15.96).

Gemechu and his collaborators recommended that training on the “screening, diagnosis and management of TB/HIV co-infection in children” be offered to all relevant health care providers. They suggested that a future prospective study on mortality in these patients be conducted to improve understanding and treatment.


Source: Archives of Public Health