TY - JOUR
T1 - Outcomes of integrated treatment for tuberculosis and HIV in children at the primary health care level
AU - Patel, M. R.
AU - Yotebieng, M.
AU - Behets, F.
AU - Vanden Driessche, K.
AU - Nana, M.
AU - Van Rie, A.
PY - 2013/9/1
Y1 - 2013/9/1
N2 - 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.
AB - 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.
KW - Antiretroviral
KW - Nurses
KW - Pediatric
KW - TB-HIV
KW - Taskshifting
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U2 - 10.5588/ijtld.12.0833
DO - 10.5588/ijtld.12.0833
M3 - Article
C2 - 23827656
AN - SCOPUS:84883007733
SN - 1027-3719
VL - 17
SP - 1206
EP - 1211
JO - International Journal of Tuberculosis and Lung Disease
JF - International Journal of Tuberculosis and Lung Disease
IS - 9
ER -
