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Tuberculosis in pediatric antiretroviral therapy programs in low- and middle-income countries : diagnosis and screening practices

Ballif, Marie and Renner, Lorna and Claude Dusingize, Jean and Leroy, Valeriane and Ayaya, Samuel and Wools-Kaloustian, Kara and Cortes, Claudia P. and McGowan, Catherine C. and Graber, Claire and Mandalakas, Anna M. and Mofenson, Lynne M. and Egger, Matthias and Kumara Wati, Ketut Dewi and Nallusamy, Revathy and Reubenson, Gary and Davies, Mary-Ann and Fenner, Lukas and International Epidemiologic Databases to Evaluate Aids, and International Epidemiologic Databases to Evaluate Aids IeDEA, . (2015) Tuberculosis in pediatric antiretroviral therapy programs in low- and middle-income countries : diagnosis and screening practices. Journal of the Pediatric Infectious Diseases Society, Vol. 4, H. 1. S. 30-38.

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Official URL: http://edoc.unibas.ch/dok/A6438839

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Abstract

The global burden of childhood tuberculosis (TB) is estimated to be 0.5 million new cases per year. Human immunodeficiency virus (HIV)-infected children are at high risk for TB. Diagnosis of TB in HIV-infected children remains a major challenge.; We describe TB diagnosis and screening practices of pediatric antiretroviral treatment (ART) programs in Africa, Asia, the Caribbean, and Central and South America. We used web-based questionnaires to collect data on ART programs and patients seen from March to July 2012. Forty-three ART programs treating children in 23 countries participated in the study.; Sputum microscopy and chest Radiograph were available at all programs, mycobacterial culture in 40 (93%) sites, gastric aspiration in 27 (63%), induced sputum in 23 (54%), and Xpert MTB/RIF in 16 (37%) sites. Screening practices to exclude active TB before starting ART included contact history in 41 sites (84%), symptom screening in 38 (88%), and chest Radiograph in 34 sites (79%). The use of diagnostic tools was examined among 146 children diagnosed with TB during the study period. Chest Radiograph was used in 125 (86%) children, sputum microscopy in 76 (52%), induced sputum microscopy in 38 (26%), gastric aspirate microscopy in 35 (24%), culture in 25 (17%), and Xpert MTB/RIF in 11 (8%) children.; Induced sputum and Xpert MTB/RIF were infrequently available to diagnose childhood TB, and screening was largely based on symptom identification. There is an urgent need to improve the capacity of ART programs in low- and middle-income countries to exclude and diagnose TB in HIV-infected children.
Faculties and Departments:09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH) > Department of Medical Parasitology and Infection Biology > Tuberculosis Research (Gagneux)
09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH)
UniBasel Contributors:Ballif, Marie and Fenner, Lukas
Item Type:Article, refereed
Bibsysno:Link to catalogue
Publisher:Oxford Univ. Press]
Note:Publication type according to Uni Basel Research Database: Journal article
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Last Modified:06 Nov 2015 10:21
Deposited On:06 Nov 2015 10:21

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