Details

Autor(en) / Beteiligte

• Elenga, Narcisse
• Kouakoussui, Kouakou Alain
• Bonard, Dominique
• Fassinou, Patricia
• Anaky, Marie-France
• Wemin, Marie-Louise
• Dick-Amon-Tanoh, Flore
• Rouet, François
• Vincent, Véronique
• Msellati, Philippe

Titel

Diagnosed Tuberculosis During the Follow-up of a Cohort of Human Immunodeficiency Virus-Infected Children in Abidjan, Côte dʼIvoire: ANRS 1278 Study

Ist Teil von

• The Pediatric infectious disease journal, 2005-12, Vol.24 (12), p.1077-1082

Ort / Verlag

Baltimore, MD: Lippincott Williams & Wilkins, Inc

Erscheinungsjahr

2005

Quelle

MEDLINE

Beschreibungen/Notizen

• INTRODUCTION:Most data on tuberculosis in human immunodeficiency virus (HIV)-infected children in Africa come from hospital-based and cross-sectional studies. OBJECTIVES:To estimate the incidence of tuberculosis in HIV-infected children participating in an observational cohort. METHODS:HIV-infected children in Abidjan, Côte dʼIvoire, are followed in a prospective cohort. At enrollment, all children had a physical examination, CD4 lymphocyte counts, chest radiograph and a tuberculin test. Quarterly follow-up visits are organized. All patients with suspected tuberculosis undergo specific investigations including gastric aspiration and culture. All isolates are tested for susceptibility. RESULTS:From October 2000 to December 2003, 129 girls and 153 boys were recruited. Of children without a current or previous diagnosis of tuberculosis, 6.5% (13 of 199) had a tuberculin test result of >5 mm, compared with 17.5% of children (10 of 57) with current or previous tuberculosis (P < 0.02). Forty-eight children (17%) had a history of treated tuberculosis, and 27 children were being treated for tuberculosis at enrollment or during the first month of follow-up. Eleven children were diagnosed with tuberculosis after the first month of follow-up, and the diagnosis of mycobacterial infection was confirmed in 7 cases. Of 5 tested isolates of Mycobacterium tuberculosis, 3 were resistant to at least 1 antitubercular drug.Cumulative incidence of tuberculosis was 2060/100,000 at 12 months, 3390/100,000 at 2 years and 5930/100,000 at 3 years. The 3-year risk was 12,400/100,000 in immunocompromised children (CD4 <15%) and 3300/100,000 in other children (P < 0.0001). CONCLUSION:The risk of tuberculosis among HIV-infected children in Côte dʼIvoire is strongly associated with the degree of immunodeficiency in HIV infection.