Tuberculosis 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%) of them 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