Abstract
IntroductionHuman immunodeficiency virus (HIV) and tuberculosis (TB) are the leading causes of death from infectious disease worldwide. The prevalence of HIV among children with TB in moderate to high prevalence countries ranges between 10% and 60%. This study aimed to determine the prevalence of HIV infection among children treated for TB in Directly Observed Treatment Short-Course (DOTS) clinics in Lubumbashi and to identify risk of death during this co-infection.MethodsThis is a cross-sectional study of children under-15, treated for tuberculosis from January 1, 2013 to December 31, 2015. Clinical, paraclinical and outcome data were collected in 22 DOTS of Lubumbashi. A statistical comparison was made between dead and survived HIV-infected TB children. We performed the multivariate analyzes and the significance level set at p-value <0.05.ResultsA total of 840 children with TB were included. The prevalence of HIV infection was 20.95% (95% CI: 18.34-23.83%). The mortality rate was higher for HIV-infected children (47.73%) compared to HIV-uninfected children (17.02%) (p<0.00001). Age <5 years (aOR=6.50 [1.96-21.50]), a poor nutritional status (aOR=23.55 [8.20-67.64]), and a negative acid-fast bacilli testing (aOR=4.51 [1.08-18.70]) were associated with death during anti-TB treatment.ConclusionTB and HIV co-infection is a reality in pediatric settings in Lubumbashi. High mortality highlights the importance of early management.
Highlights
Human immunodeficiency virus (HIV) and tuberculosis (TB) are the leading causes of death from infectious disease worldwide
A total of 840 children with TB were included, of whom 176 were HIVinfected, an HIV infection of 20.95%
The same is true for nutritional status, we noted that 45.45% of HIV-infected children had a weight-for-age zscore ≤-2 SD against 18.83% in HIV-uninfected children (p
Summary
Human immunodeficiency virus (HIV) and tuberculosis (TB) are the leading causes of death from infectious disease worldwide. The most important chronic diseases affecting children in subSaharan Africa are tuberculosis (TB), Human Immunodeficiency Virus (HIV) infection and malnutrition. These three diseases often have similar clinical aspects or are frequently associated with the same patient. HIV infection is the main risk factor for tuberculosis because HIV promotes the progression of latent or recent infections of Mycobacterium tuberculosis into active disease and increases the frequency of TB [2,3] Both pathologies are the two leading causes of infectious disease deaths worldwide [4]. WHO estimates that HIV prevalence among children with TB in medium and high prevalence countries is between 10% and 60% [8,9] and varies with background rates of HIV infection [10]
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