Prevalence of and risk factors for pulmonary tuberculosis among newly diagnosed HIV-1 infected Nigerian children

• Published in: Germs (Bucureşti) Vol. 6; no. 1; pp. 21 - 28
• Main Authors: Ebonyi, Augustine O, Oguche, Stephen, Ejeliogu, Emeka U, Agbaji, Oche O, Shehu, Nathan Y, Abah, Isaac O, Sagay, Atiene S, Ugoagwu, Placid O, Okonkwo, Prosper I, Idoko, John A, Kanki, Phyllis J
• Format: Journal Article
• Language: English
• Published: Romania Asociatia pentru Cresterea Vizibilitatii Cercetarii Stiintifice (ACVCS) 01.03.2016; European HIV/AIDS and Infectious Diseases Academy; National Institute of Infectious Diseases “Prof. Dr. Matei Balş”, Romania, and the European Academy of HIV/AIDS and Infectious Diseases
• Subjects: Acquired immune deficiency syndrome; Age; AIDS; Anemia; Children & youth; Clinical outcomes; Funding; HIV; Human immunodeficiency virus; Immunotherapy; Infections; Laboratories; Malnutrition; Medical research; Microscopy; Original; Pediatrics; Prevalence studies (Epidemiology); Public health; Statistical analysis; Tuberculosis; Variables; Nigeria; United States > US; HIV-1; WHO HIV clinical stage; co-infection; children; severe immunosuppression; PTB
• ISSN: 2248-2997; 2248-2997
• DOI: 10.11599/germs.2016.1085

Studies on the prevalence of and risk factors for tuberculosis (TB) among newly diagnosed human immunodeficiency virus (HIV)-infected children in sub-Saharan Africa are scarce and in Nigeria there is paucity of reported data. We determined the prevalence of and risk factors for pulmonary TB (PTB) in newly diagnosed (treatment-naïve) HIV-1 infected children at the pediatric HIV clinic of the Jos University Teaching Hospital (JUTH) in Nigeria. We performed a retrospective analysis of 876 children, aged 2 months - 13 years, diagnosed with HIV-1 infection between July 2005 and December 2012, of which 286 were diagnosed with PTB at presentation after TB screening. The study site was the AIDS Prevention Initiative in Nigeria (APIN)-supported Pediatric HIV clinic at JUTH, Jos. A multivariate forward logistic regression modelling was used to identify risk factors for PTB-HIV co-infection. The prevalence of PTB-HIV co-infection was 32% (286/876). Severe immunosuppression (SI) and World Health Organization (WHO) HIV clinical stage 3/4 were identified as independent risk factors for PTB-HIV co-infection in HIV infected children. The odds of PTB-HIV co-infection was increased two-fold in HIV-infected children with WHO clinical stage 3/4 compared to those with stage 1/2 (adjusted odds ratio (AOR) 1.76 [1.31-2.37], p<0.001) and 1.5-fold in children with SI compared to those without SI (AOR 1.52 [1.12-2.06], p=0.007). In our setting, the burden of PTB was high among newly diagnosed HIV-infected children, and late WHO HIV clinical stage and severe immunosuppression were associated with PTB-HIV co-infection. Therefore there is a clear need to improve strategies for early diagnosis of both HIV and PTB to optimize clinical outcomes.