Impact of the Antiretroviral Treatment Program on the Burden of Hospitalization for Culture-confirmed Tuberculosis in South African Children: A Time-series Analysis
The HIV epidemic increased the burden of tuberculosis (TB) in sub-Saharan Africa. We evaluated the impact that scaling-up of the public-funded antiretroviral treatment (ART) program had on incidence of hospitalization for culture-confirmed and overall-TB in HIV-infected and HIV-uninfected children f...
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| Veröffentlicht in: | The Pediatric infectious disease journal 2013-09, Vol.32 (9), p.972-977 |
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| container_title | The Pediatric infectious disease journal |
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| creator | DANGOR, Ziyaad IZU, Alane HILLIER, Kelty SOLOMON, Fatima BEYLIS, Natalie MOORE, David P NUNES, Marta C MADHI, Shabir A |
| description | The HIV epidemic increased the burden of tuberculosis (TB) in sub-Saharan Africa. We evaluated the impact that scaling-up of the public-funded antiretroviral treatment (ART) program had on incidence of hospitalization for culture-confirmed and overall-TB in HIV-infected and HIV-uninfected children from 2005 to 2009.
The study was undertaken in Soweto, South Africa, where ART coverage of HIV-infected children increased from 43% in 2005 to 84% by 2009. Trends in incidence of hospitalization for clinically diagnosed and culture-confirmed TB in children 3 months to |
| doi_str_mv | 10.1097/INF.0b013e31828d9aa4 |
| format | Article |
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The study was undertaken in Soweto, South Africa, where ART coverage of HIV-infected children increased from 43% in 2005 to 84% by 2009. Trends in incidence of hospitalization for clinically diagnosed and culture-confirmed TB in children 3 months to <15 years of age, identified through laboratory and electronic databases, were analyzed by comparing crude incidence and regression analysis.
The incidence (per 100,000) of culture-confirmed TB declined by 63.1% from 2005 (69.8) compared with 2009 (25.8; P < 0.0001). This included a 70.6% reduction between 2005 and 2009 among HIV-infected children (incidence: 1566.3 versus 460.7, respectively; P < 0.0001) and 41.3% decrease in HIV-uninfected children (18.7 versus 11.0, respectively; P = 0.0003). The month-by-month rate of decline of culture-confirmed TB was 2.3% in HIV-infected and 1.1% in HIV-uninfected children over the study period. The residual burden of TB remained 42-fold greater in HIV-infected children, 78% of whom were severely immune compromised, compared with HIV-uninfected children by 2009.
Increase in ART coverage was associated with significant decline in TB hospitalizations in HIV-infected children. This reduction may also in part have been due to reduced Mycobacterium tuberculosis transmission resulting from increased ART access among HIV-infected adults, which may have contributed to the reduction of culture-confirmed TB in HIV-uninfected children.</description><identifier>ISSN: 0891-3668</identifier><identifier>EISSN: 1532-0987</identifier><identifier>DOI: 10.1097/INF.0b013e31828d9aa4</identifier><identifier>PMID: 23503163</identifier><identifier>CODEN: PIDJEV</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins</publisher><subject>Adolescent ; Anti-Retroviral Agents - therapeutic use ; Antibiotics. Antiinfectious agents. Antiparasitic agents ; Antiviral agents ; Bacterial diseases ; Biological and medical sciences ; Child ; Child, Preschool ; Female ; HIV Infections - complications ; HIV Infections - drug therapy ; Hospitalization - statistics & numerical data ; Human bacterial diseases ; Human viral diseases ; Humans ; Incidence ; Infant ; Infectious diseases ; Male ; Medical sciences ; Mycobacterium tuberculosis - isolation & purification ; Pharmacology. Drug treatments ; Retrospective Studies ; South Africa - epidemiology ; Tuberculosis - epidemiology ; Tuberculosis - microbiology ; Tuberculosis and atypical mycobacterial infections ; Viral diseases ; Viral diseases of the lymphoid tissue and the blood. Aids</subject><ispartof>The Pediatric infectious disease journal, 2013-09, Vol.32 (9), p.972-977</ispartof><rights>2014 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c356t-c2a2cd7feddefc9ef85e5ae927cfe7061505839ccdb54558651022c193606e803</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27923,27924</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=27734823$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23503163$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>DANGOR, Ziyaad</creatorcontrib><creatorcontrib>IZU, Alane</creatorcontrib><creatorcontrib>HILLIER, Kelty</creatorcontrib><creatorcontrib>SOLOMON, Fatima</creatorcontrib><creatorcontrib>BEYLIS, Natalie</creatorcontrib><creatorcontrib>MOORE, David P</creatorcontrib><creatorcontrib>NUNES, Marta C</creatorcontrib><creatorcontrib>MADHI, Shabir A</creatorcontrib><title>Impact of the Antiretroviral Treatment Program on the Burden of Hospitalization for Culture-confirmed Tuberculosis in South African Children: A Time-series Analysis</title><title>The Pediatric infectious disease journal</title><addtitle>Pediatr Infect Dis J</addtitle><description>The HIV epidemic increased the burden of tuberculosis (TB) in sub-Saharan Africa. We evaluated the impact that scaling-up of the public-funded antiretroviral treatment (ART) program had on incidence of hospitalization for culture-confirmed and overall-TB in HIV-infected and HIV-uninfected children from 2005 to 2009.
The study was undertaken in Soweto, South Africa, where ART coverage of HIV-infected children increased from 43% in 2005 to 84% by 2009. Trends in incidence of hospitalization for clinically diagnosed and culture-confirmed TB in children 3 months to <15 years of age, identified through laboratory and electronic databases, were analyzed by comparing crude incidence and regression analysis.
The incidence (per 100,000) of culture-confirmed TB declined by 63.1% from 2005 (69.8) compared with 2009 (25.8; P < 0.0001). This included a 70.6% reduction between 2005 and 2009 among HIV-infected children (incidence: 1566.3 versus 460.7, respectively; P < 0.0001) and 41.3% decrease in HIV-uninfected children (18.7 versus 11.0, respectively; P = 0.0003). The month-by-month rate of decline of culture-confirmed TB was 2.3% in HIV-infected and 1.1% in HIV-uninfected children over the study period. The residual burden of TB remained 42-fold greater in HIV-infected children, 78% of whom were severely immune compromised, compared with HIV-uninfected children by 2009.
Increase in ART coverage was associated with significant decline in TB hospitalizations in HIV-infected children. This reduction may also in part have been due to reduced Mycobacterium tuberculosis transmission resulting from increased ART access among HIV-infected adults, which may have contributed to the reduction of culture-confirmed TB in HIV-uninfected children.</description><subject>Adolescent</subject><subject>Anti-Retroviral Agents - therapeutic use</subject><subject>Antibiotics. Antiinfectious agents. Antiparasitic agents</subject><subject>Antiviral agents</subject><subject>Bacterial diseases</subject><subject>Biological and medical sciences</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Female</subject><subject>HIV Infections - complications</subject><subject>HIV Infections - drug therapy</subject><subject>Hospitalization - statistics & numerical data</subject><subject>Human bacterial diseases</subject><subject>Human viral diseases</subject><subject>Humans</subject><subject>Incidence</subject><subject>Infant</subject><subject>Infectious diseases</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Mycobacterium tuberculosis - isolation & purification</subject><subject>Pharmacology. Drug treatments</subject><subject>Retrospective Studies</subject><subject>South Africa - epidemiology</subject><subject>Tuberculosis - epidemiology</subject><subject>Tuberculosis - microbiology</subject><subject>Tuberculosis and atypical mycobacterial infections</subject><subject>Viral diseases</subject><subject>Viral diseases of the lymphoid tissue and the blood. Aids</subject><issn>0891-3668</issn><issn>1532-0987</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkcGKFDEQhoMo7rj6BiK5CF56TTqd7sTb7OC6A4sKjucmk644kXQyVhJhfR4f1F53VPBUh_q-qqJ-Qp5zdsGZHl5v319dsD3jAgRXrZq0Md0DsuJStA3TanhIVkxp3oi-V2fkSc5fGWOi4-wxOWuFZIL3YkV-buejsYUmR8sB6DoWj1AwffdoAt0hmDJDLPQjpi9oZprib-6y4gTxzrpO-eiLCf6HKX7puoR0U0OpCI1N0XmcYaK7uge0NaTsM_WRfkq1HOjaobcm0s3BhwkhvqFruvMzNBnQQ16uMeF2MZ6SR86EDM9O9Zx8vnq721w3Nx_ebTfrm8YK2ZfGtqa10-BgmsBZDU5JkAZ0O1gHA-u5ZFIJbe20l52Uqpecta3lWvSsB8XEOXl1P_eI6VuFXMbZZwshmAip5pF3nRBad1IvaHePWkw5I7jxiH42eDtyNt7lMy75jP_ns2gvThvqfvnLX-lPIAvw8gSYbE1waKL1-R83DKJTrRC_ALMgnSw</recordid><startdate>20130901</startdate><enddate>20130901</enddate><creator>DANGOR, Ziyaad</creator><creator>IZU, Alane</creator><creator>HILLIER, Kelty</creator><creator>SOLOMON, Fatima</creator><creator>BEYLIS, Natalie</creator><creator>MOORE, David P</creator><creator>NUNES, Marta C</creator><creator>MADHI, Shabir A</creator><general>Lippincott Williams & Wilkins</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20130901</creationdate><title>Impact of the Antiretroviral Treatment Program on the Burden of Hospitalization for Culture-confirmed Tuberculosis in South African Children: A Time-series Analysis</title><author>DANGOR, Ziyaad ; IZU, Alane ; HILLIER, Kelty ; SOLOMON, Fatima ; BEYLIS, Natalie ; MOORE, David P ; NUNES, Marta C ; MADHI, Shabir A</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c356t-c2a2cd7feddefc9ef85e5ae927cfe7061505839ccdb54558651022c193606e803</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Adolescent</topic><topic>Anti-Retroviral Agents - therapeutic use</topic><topic>Antibiotics. Antiinfectious agents. Antiparasitic agents</topic><topic>Antiviral agents</topic><topic>Bacterial diseases</topic><topic>Biological and medical sciences</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Female</topic><topic>HIV Infections - complications</topic><topic>HIV Infections - drug therapy</topic><topic>Hospitalization - statistics & numerical data</topic><topic>Human bacterial diseases</topic><topic>Human viral diseases</topic><topic>Humans</topic><topic>Incidence</topic><topic>Infant</topic><topic>Infectious diseases</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Mycobacterium tuberculosis - isolation & purification</topic><topic>Pharmacology. Drug treatments</topic><topic>Retrospective Studies</topic><topic>South Africa - epidemiology</topic><topic>Tuberculosis - epidemiology</topic><topic>Tuberculosis - microbiology</topic><topic>Tuberculosis and atypical mycobacterial infections</topic><topic>Viral diseases</topic><topic>Viral diseases of the lymphoid tissue and the blood. Aids</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>DANGOR, Ziyaad</creatorcontrib><creatorcontrib>IZU, Alane</creatorcontrib><creatorcontrib>HILLIER, Kelty</creatorcontrib><creatorcontrib>SOLOMON, Fatima</creatorcontrib><creatorcontrib>BEYLIS, Natalie</creatorcontrib><creatorcontrib>MOORE, David P</creatorcontrib><creatorcontrib>NUNES, Marta C</creatorcontrib><creatorcontrib>MADHI, Shabir A</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Pediatric infectious disease journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>DANGOR, Ziyaad</au><au>IZU, Alane</au><au>HILLIER, Kelty</au><au>SOLOMON, Fatima</au><au>BEYLIS, Natalie</au><au>MOORE, David P</au><au>NUNES, Marta C</au><au>MADHI, Shabir A</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impact of the Antiretroviral Treatment Program on the Burden of Hospitalization for Culture-confirmed Tuberculosis in South African Children: A Time-series Analysis</atitle><jtitle>The Pediatric infectious disease journal</jtitle><addtitle>Pediatr Infect Dis J</addtitle><date>2013-09-01</date><risdate>2013</risdate><volume>32</volume><issue>9</issue><spage>972</spage><epage>977</epage><pages>972-977</pages><issn>0891-3668</issn><eissn>1532-0987</eissn><coden>PIDJEV</coden><abstract>The HIV epidemic increased the burden of tuberculosis (TB) in sub-Saharan Africa. We evaluated the impact that scaling-up of the public-funded antiretroviral treatment (ART) program had on incidence of hospitalization for culture-confirmed and overall-TB in HIV-infected and HIV-uninfected children from 2005 to 2009.
The study was undertaken in Soweto, South Africa, where ART coverage of HIV-infected children increased from 43% in 2005 to 84% by 2009. Trends in incidence of hospitalization for clinically diagnosed and culture-confirmed TB in children 3 months to <15 years of age, identified through laboratory and electronic databases, were analyzed by comparing crude incidence and regression analysis.
The incidence (per 100,000) of culture-confirmed TB declined by 63.1% from 2005 (69.8) compared with 2009 (25.8; P < 0.0001). This included a 70.6% reduction between 2005 and 2009 among HIV-infected children (incidence: 1566.3 versus 460.7, respectively; P < 0.0001) and 41.3% decrease in HIV-uninfected children (18.7 versus 11.0, respectively; P = 0.0003). The month-by-month rate of decline of culture-confirmed TB was 2.3% in HIV-infected and 1.1% in HIV-uninfected children over the study period. The residual burden of TB remained 42-fold greater in HIV-infected children, 78% of whom were severely immune compromised, compared with HIV-uninfected children by 2009.
Increase in ART coverage was associated with significant decline in TB hospitalizations in HIV-infected children. This reduction may also in part have been due to reduced Mycobacterium tuberculosis transmission resulting from increased ART access among HIV-infected adults, which may have contributed to the reduction of culture-confirmed TB in HIV-uninfected children.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins</pub><pmid>23503163</pmid><doi>10.1097/INF.0b013e31828d9aa4</doi><tpages>6</tpages></addata></record> |
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| subjects | Adolescent Anti-Retroviral Agents - therapeutic use Antibiotics. Antiinfectious agents. Antiparasitic agents Antiviral agents Bacterial diseases Biological and medical sciences Child Child, Preschool Female HIV Infections - complications HIV Infections - drug therapy Hospitalization - statistics & numerical data Human bacterial diseases Human viral diseases Humans Incidence Infant Infectious diseases Male Medical sciences Mycobacterium tuberculosis - isolation & purification Pharmacology. Drug treatments Retrospective Studies South Africa - epidemiology Tuberculosis - epidemiology Tuberculosis - microbiology Tuberculosis and atypical mycobacterial infections Viral diseases Viral diseases of the lymphoid tissue and the blood. Aids |
| title | Impact of the Antiretroviral Treatment Program on the Burden of Hospitalization for Culture-confirmed Tuberculosis in South African Children: A Time-series Analysis |
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