Outcomes of integrated treatment for tuberculosis and HIV in children at the primary health care level

M. R. Patel, M. Yotebieng, F. Behets, K. Vanden Driessche, M. Nana, A. Van Rie

Research output: Contribution to journalArticle

12 Scopus citations

Abstract

BACKGROUND: Little is known about the integration of tuberculosis (TB) and human immunodeficiency virus (HIV) treatment in pediatric populations. METHODS: Prospective cohort of 31 HIV-infected children aged 3-18 years initiating anti-tuberculosis treatment at five primary health care (PHC) clinics in Kinshasa, Democratic Republic of Congo, to describe survival, clinical and immunological outcomes of nurse-centered integrated TB-HIV treatment. RESULTS: Almost all of the children (87.1%) were diagnosed with HIV during TB diagnosis. Most (87.0%) were successfully treated for TB. Two (6.5%) died during anti-tuberculosis treatment; both presented with low CD4 counts (36 and 59 cells/mm3 compared to a median of 228 cells/mm3 in the entire cohort). Most (74.2%) initiated antiretroviral therapy (ART) during anti-tuberculosis treatment. Overall, a median CD4 count increase of 106 cells/mm3 was observed (P = 0.014), an increase of 113 cells/mm 3 among children on ART and of 71.5 cells/mm3 in those not on ART (P = 0.78). Median body mass index increase during antit uberculosis treatment was 2.1 kg/m2 overall (P = 0.002), 2.2 kg/m2 among children on ART and 0.72 kg/m2 in those not on ART (P = 0.08). CONCLUSION: Integrated, nurse-centered, pediatric TBHIV treatment at the PHC level in highly resource-l imited settings is feasible and effective in achieving successful outcomes, including high ART uptake, low mortality, and immunological and clinical improvement.

Original languageEnglish (US)
Pages (from-to)1206-1211
Number of pages6
JournalInternational Journal of Tuberculosis and Lung Disease
Volume17
Issue number9
DOIs
StatePublished - Sep 1 2013
Externally publishedYes

Keywords

  • Antiretroviral
  • Nurses
  • Pediatric
  • TB-HIV
  • Taskshifting

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Infectious Diseases

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