Incidence and predictors of tuberculosis among children on antiretroviral therapy at northeast Ethiopia comprehensive specialized hospitals, 2022; A multicenter retrospective follow-up study

Birrie, Endalk; Chanie, Ermias Sisay; Gebreeyesus, FishaAlebel; Biset, Gebeyaw; Tefera, Birhanu Desu; Zeleke, Mulusew

doi:10.1016/j.heliyon.2022.e12001

Cited by 5 publications

(14 citation statements)

References 32 publications

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“…The compromised immune response associated with advanced disease stages contributes to the development of active TB. 6,34 Marital status significantly influences the risk of active TB incidence among patients starting second-line ART treatment. PLHIV living with their spouse on second-line ART had a 79.7% lower risk of active TB compared to the divorced and widowed groups (AHR = 0.203, 95% CI: 0.045-0.907, p = 0.001).…”

Section: Discussionmentioning

confidence: 99%

“…Patients in advanced disease stages (III and IV) may experience weakened immunity, leading to accelerated endogenous reactivation and an increased risk of latent bacilli becoming active TB in the lungs. The compromised immune response associated with advanced disease stages contributes to the development of active TB 6,34 …”

Section: Discussionmentioning

confidence: 99%

“…The compromised immune response associated with advanced disease stages contributes to the development of active TB. 6 , 34 …”

Section: Discussionmentioning

confidence: 99%

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Active tuberculosis incidence among treatment failure experienced patients in North Wollow Zone: A multicenter historical cohort

Bizuneh,

Masresha,

Yayeh

et al. 2024

Health Science Reports

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BackgroundIn Ethiopia, tuberculosis (TB) is a significant cause of death among individuals living with HIV, especially in resource‐limited areas and those who have experienced treatment failure. However, there is the paucity of data regarding TB among treatment failures experienced people living with HIV. This study aimed to estimate the rate and identify predictors of tuberculosis among patients who received second‐line treatment in North Wollo, Northeast Ethiopia.MethodsA retrospective follow‐up study was conducted on 474 HIV‐infected patients who experienced treatment failure. The study period ranged from January 2015 to September 30, 2021. The incidence of TB was assessed using a Cox proportional hazard regression model, after ensuring that all assumptions were met. Factors associated with active TB were determined by analyzing adjusted hazard ratios and 95% confidence intervals.ResultsIn a study of 474 HIV‐positive patients on second‐line antiretroviral treatment, we found an incidence rate of 3.6% with 17 new cases of TB observed over 4412.4 persons per year (PPY). The overall incidence density rate was estimated to be 0.39 cases per 100 PPY (95% CI: 0.239–0.618). Regarding the occurrence of active TB in second‐line patients, WHO clinical treatment stage (T3 and T4), missed isoniazid preventive therapy had a significantly higher risk (AHR: 13.225, 95% CI: 2.894–60.434, p = 0.001), while being married was associated with a lower risk (AHR: 0.203, 95% CI: 0.045–0.907, p = 0.001).ConclusionA high incidence of active TB was observed shortly after initiating second‐line antiretroviral treatment. Factors such as being in the WHO clinical treatment stage (T3 and T4) and marital status were determinants for active TB. To improve overall survival rates, it is vital to enhance early TB screening and implement effective isoniazid preventive therapy.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Active tuberculosis incidence among treatment failure experienced patients in North Wollow Zone: A multicenter historical cohort

Bizuneh,

Masresha,

Yayeh

et al. 2024

Health Science Reports

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“…The scores were summed and changed to percentages. Finally, 13 studies that received a quality score of > 50% were included in this meta-analysis [17][18][19][20][21][22][23][24][25][26][30][31][32] (Additional Table 2).…”

Section: Quality Assessment/critical Appraisalmentioning

confidence: 99%

“…In Ethiopia, studies revealed that the incidence of TB among HIV-infected children varies across regions with the highest rate (9.6 per 100 person-years) in the Benshangul Gumz region [17] to the lowest rate (2 per 100 person-years)in the Amhara region [18]. Similarly, other previous primary studies have also reported inconsistent findings regarding the incidence of TB among HIV-positive children [17][18][19][20][21][22][23][24][25][26]. With this discrepancy, the pooled incidence rate of TB for children (aged 0-14 years) living with HIV is not estimated.…”

Section: Introductionmentioning

confidence: 99%

Incidence rate of tuberculosis among HIV infected children in Ethiopia: systematic review and meta-analysis

Girma,

Abita,

Shifera

et al. 2024

BMC Pediatr

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Background Tuberculosis is one the leading causes of death from a single infectious disease, caused by the bacillus mycobacterium tuberculosis. In Ethiopia, even though several primary studies have been conducted on the incidence of tuberculosis among HIV-infected children, the pooled incidence rate of tuberculosis among HIV-infected children (aged 0–14 years) is unknown. Therefore, the main objectives of this systematic review and meta-analysis are to estimate the pooled incidence rate of tuberculosis among HIV-infected children and its predictors in Ethiopia. Method International electronic databases such as PubMed, HINARI, Science Direct, Google Scholar, and African Journals Online were searched using different search engines. Quality of primary studies was checked using the Joanna Briggs Institute checklist. The heterogeneity of studies was tested using I-square statistics. Publication bias was tested using a funnel plot and Egger’s test. Forest plots and tables were used to present the results. The random effect model was used to estimate the pooled incidence of tuberculosis among children living with HIV. Result A total of 13 studies were included in this systematic review and meta-analysis. The pooled incidence of tuberculosis among HIV-infected children was 3.77 (95% CI: 2.83, 5.02) per 100-person-year observations. Advanced HIV disease (HR: 2.72, 95% CI: 1.9; 3.88), didn’t receive complete vaccination (HR: 4.40, 95% CI: 2.16; 8.82), stunting (HR: 2.34, 95% CI: 1.64, 3.33), underweight (HR: 2.30, 95% CI: 1.61; 3.22), didn’t receive Isoniazid preventive therapy (HR: 3.64, 95% CI: 2.22, 5.96), anemia (HR: 3.04, 95% CI: 2.34; 3.98), fair or poor antiretroviral therapy adherence (HR: 2.50, 95% CI: 1.84; 3.40) and didn’t receive cotrimoxazole preventive therapy (HR: 3.20, 95% CI: 2.26; 4.40) were predictors of tuberculosis coinfection among HIV infected children. Conclusion This systematic review and meta-analysis concluded that the overall pooled incidence rate of tuberculosis among HIV-infected children was high in Ethiopia as compared to the END TB strategy targets. Therefore, emphasis has to be given to drug adherence (ART and Isoniazid) and nutritional counseling. Moreover, early diagnosis and treatment of malnutrition and anemia are critical to reduce the risk of TB coinfection. Registration Registered in PROSPERO with ID: CRD42023474956.

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Epidemiological survival pattern, risk factors, and estimated time to develop tuberculosis after test and treat strategies declared for children living with human immune deficiency virus

Tsegaye,

Wude,

Kebede

et al. 2023

Indian Journal of Tuberculosis

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Incidence and predictors of tuberculosis among children on antiretroviral therapy at northeast Ethiopia comprehensive specialized hospitals, 2022; A multicenter retrospective follow-up study

Cited by 5 publications

References 32 publications

Active tuberculosis incidence among treatment failure experienced patients in North Wollow Zone: A multicenter historical cohort

Active tuberculosis incidence among treatment failure experienced patients in North Wollow Zone: A multicenter historical cohort

Incidence rate of tuberculosis among HIV infected children in Ethiopia: systematic review and meta-analysis

Epidemiological survival pattern, risk factors, and estimated time to develop tuberculosis after test and treat strategies declared for children living with human immune deficiency virus

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