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

Marie Ballif, Lorna Renner, Jean Claude Dusingize, Valeriane Leroy, Samuel Ayaya, Kara Wools-Kaloustian, Claudia P. Cortes, Catherine C. McGowan, Claire Graber, Anna M. Mandalakas, Lynne M. Mofenson, Matthias Egger, Ketut Dewi Kumara Wati, Revathy Nallusamy, Gary Reubenson, Mary Ann Davies, Lukas Fenner*, Samuel Ajayi, Kathryn Anastos, Jules BashiWilliam Bishai, Andrew Boulle, Paula Braitstein, Gabriela Carriquiry, Jane E. Carter, Peter Cegielski, Cleophas Chimbetete, Claudia Cortes, Mary Ann Davies, Lameck Diero, Stephany Duda, Nicolas Durier, Tanoh F. Eboua, Adrian Gasser, Elvin Geng, Joachim Charles Gnokori, Chris Hoffmann, Nzali Kancheya, Sasisopin Kiertiburanakul, Peter Kim, Diero Lameck, Charlotte Lewden, Mary Lou Lindegren, Anna Mandalakas, Mhairi Maskew, Lynne Mofenson, Mireille Mpoudi-Etame, Benson Okwara, Sam Phiri, Firas Wehbe, for the International Epidemiologic Databases to Evaluate AIDS (IeDEA)

*Corresponding author for this work

    Research output: Contribution to journalArticle

    6 Citations (Scopus)

    Abstract

    Background. 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 HIVinfected children remains a major challenge. Methods. 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. Results. 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. Conclusions. 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.

    Original languageEnglish (US)
    Pages (from-to)30-38
    Number of pages9
    JournalJournal of the Pediatric Infectious Diseases Society
    Volume4
    Issue number1
    DOIs
    StatePublished - Jan 1 2015

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    Tuberculosis
    Pediatrics
    Sputum
    Microscopy
    Thorax
    Therapeutics
    Stomach
    HIV
    Central America
    South America
    History

    Keywords

    • HIV
    • Low-income countries
    • Pediatric
    • Survey
    • Tuberculosis

    ASJC Scopus subject areas

    • Pediatrics, Perinatology, and Child Health
    • Infectious Diseases

    Cite this

    Ballif, M., Renner, L., Dusingize, J. C., Leroy, V., Ayaya, S., Wools-Kaloustian, K., ... for the 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, 4(1), 30-38. https://doi.org/10.1093/jpids/piu020
    Ballif, Marie ; Renner, Lorna ; Dusingize, Jean Claude ; Leroy, Valeriane ; Ayaya, Samuel ; Wools-Kaloustian, Kara ; Cortes, Claudia P. ; McGowan, Catherine C. ; Graber, Claire ; Mandalakas, Anna M. ; Mofenson, Lynne M. ; Egger, Matthias ; Wati, Ketut Dewi Kumara ; Nallusamy, Revathy ; Reubenson, Gary ; Davies, Mary Ann ; Fenner, Lukas ; Ajayi, Samuel ; Anastos, Kathryn ; Bashi, Jules ; Bishai, William ; Boulle, Andrew ; Braitstein, Paula ; Carriquiry, Gabriela ; Carter, Jane E. ; Cegielski, Peter ; Chimbetete, Cleophas ; Cortes, Claudia ; Davies, Mary Ann ; Diero, Lameck ; Duda, Stephany ; Durier, Nicolas ; Eboua, Tanoh F. ; Gasser, Adrian ; Geng, Elvin ; Gnokori, Joachim Charles ; Hoffmann, Chris ; Kancheya, Nzali ; Kiertiburanakul, Sasisopin ; Kim, Peter ; Lameck, Diero ; Lewden, Charlotte ; Lou Lindegren, Mary ; Mandalakas, Anna ; Maskew, Mhairi ; Mofenson, Lynne ; Mpoudi-Etame, Mireille ; Okwara, Benson ; Phiri, Sam ; Wehbe, Firas ; for the International Epidemiologic Databases to Evaluate AIDS (IeDEA). / Tuberculosis in pediatric antiretroviral therapy programs in low- and middle-income countries : Diagnosis and screening practices. In: Journal of the Pediatric Infectious Diseases Society. 2015 ; Vol. 4, No. 1. pp. 30-38.
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    abstract = "Background. 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 HIVinfected children remains a major challenge. Methods. 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. Results. 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. Conclusions. 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.",
    keywords = "HIV, Low-income countries, Pediatric, Survey, Tuberculosis",
    author = "Marie Ballif and Lorna Renner and Dusingize, {Jean Claude} and Valeriane Leroy and Samuel Ayaya and Kara Wools-Kaloustian and Cortes, {Claudia P.} and McGowan, {Catherine C.} and Claire Graber and Mandalakas, {Anna M.} and Mofenson, {Lynne M.} and Matthias Egger and Wati, {Ketut Dewi Kumara} and Revathy Nallusamy and Gary Reubenson and Davies, {Mary Ann} and Lukas Fenner and Samuel Ajayi and Kathryn Anastos and Jules Bashi and William Bishai and Andrew Boulle and Paula Braitstein and Gabriela Carriquiry and Carter, {Jane E.} and Peter Cegielski and Cleophas Chimbetete and Claudia Cortes and Davies, {Mary Ann} and Lameck Diero and Stephany Duda and Nicolas Durier and Eboua, {Tanoh F.} and Adrian Gasser and Elvin Geng and Gnokori, {Joachim Charles} and Chris Hoffmann and Nzali Kancheya and Sasisopin Kiertiburanakul and Peter Kim and Diero Lameck and Charlotte Lewden and {Lou Lindegren}, Mary and Anna Mandalakas and Mhairi Maskew and Lynne Mofenson and Mireille Mpoudi-Etame and Benson Okwara and Sam Phiri and Firas Wehbe and {for the International Epidemiologic Databases to Evaluate AIDS (IeDEA)}",
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    Ballif, M, Renner, L, Dusingize, JC, Leroy, V, Ayaya, S, Wools-Kaloustian, K, Cortes, CP, McGowan, CC, Graber, C, Mandalakas, AM, Mofenson, LM, Egger, M, Wati, KDK, Nallusamy, R, Reubenson, G, Davies, MA, Fenner, L, Ajayi, S, Anastos, K, Bashi, J, Bishai, W, Boulle, A, Braitstein, P, Carriquiry, G, Carter, JE, Cegielski, P, Chimbetete, C, Cortes, C, Davies, MA, Diero, L, Duda, S, Durier, N, Eboua, TF, Gasser, A, Geng, E, Gnokori, JC, Hoffmann, C, Kancheya, N, Kiertiburanakul, S, Kim, P, Lameck, D, Lewden, C, Lou Lindegren, M, Mandalakas, A, Maskew, M, Mofenson, L, Mpoudi-Etame, M, Okwara, B, Phiri, S, Wehbe, F & for the 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, no. 1, pp. 30-38. https://doi.org/10.1093/jpids/piu020

    Tuberculosis in pediatric antiretroviral therapy programs in low- and middle-income countries : Diagnosis and screening practices. / Ballif, Marie; Renner, Lorna; Dusingize, Jean Claude; Leroy, Valeriane; Ayaya, Samuel; Wools-Kaloustian, Kara; Cortes, Claudia P.; McGowan, Catherine C.; Graber, Claire; Mandalakas, Anna M.; Mofenson, Lynne M.; Egger, Matthias; Wati, Ketut Dewi Kumara; Nallusamy, Revathy; Reubenson, Gary; Davies, Mary Ann; Fenner, Lukas; Ajayi, Samuel; Anastos, Kathryn; Bashi, Jules; Bishai, William; Boulle, Andrew; Braitstein, Paula; Carriquiry, Gabriela; Carter, Jane E.; Cegielski, Peter; Chimbetete, Cleophas; Cortes, Claudia; Davies, Mary Ann; Diero, Lameck; Duda, Stephany; Durier, Nicolas; Eboua, Tanoh F.; Gasser, Adrian; Geng, Elvin; Gnokori, Joachim Charles; Hoffmann, Chris; Kancheya, Nzali; Kiertiburanakul, Sasisopin; Kim, Peter; Lameck, Diero; Lewden, Charlotte; Lou Lindegren, Mary; Mandalakas, Anna; Maskew, Mhairi; Mofenson, Lynne; Mpoudi-Etame, Mireille; Okwara, Benson; Phiri, Sam; Wehbe, Firas; for the International Epidemiologic Databases to Evaluate AIDS (IeDEA).

    In: Journal of the Pediatric Infectious Diseases Society, Vol. 4, No. 1, 01.01.2015, p. 30-38.

    Research output: Contribution to journalArticle

    TY - JOUR

    T1 - Tuberculosis in pediatric antiretroviral therapy programs in low- and middle-income countries

    T2 - Diagnosis and screening practices

    AU - Ballif, Marie

    AU - Renner, Lorna

    AU - Dusingize, Jean Claude

    AU - Leroy, Valeriane

    AU - Ayaya, Samuel

    AU - Wools-Kaloustian, Kara

    AU - Cortes, Claudia P.

    AU - McGowan, Catherine C.

    AU - Graber, Claire

    AU - Mandalakas, Anna M.

    AU - Mofenson, Lynne M.

    AU - Egger, Matthias

    AU - Wati, Ketut Dewi Kumara

    AU - Nallusamy, Revathy

    AU - Reubenson, Gary

    AU - Davies, Mary Ann

    AU - Fenner, Lukas

    AU - Ajayi, Samuel

    AU - Anastos, Kathryn

    AU - Bashi, Jules

    AU - Bishai, William

    AU - Boulle, Andrew

    AU - Braitstein, Paula

    AU - Carriquiry, Gabriela

    AU - Carter, Jane E.

    AU - Cegielski, Peter

    AU - Chimbetete, Cleophas

    AU - Cortes, Claudia

    AU - Davies, Mary Ann

    AU - Diero, Lameck

    AU - Duda, Stephany

    AU - Durier, Nicolas

    AU - Eboua, Tanoh F.

    AU - Gasser, Adrian

    AU - Geng, Elvin

    AU - Gnokori, Joachim Charles

    AU - Hoffmann, Chris

    AU - Kancheya, Nzali

    AU - Kiertiburanakul, Sasisopin

    AU - Kim, Peter

    AU - Lameck, Diero

    AU - Lewden, Charlotte

    AU - Lou Lindegren, Mary

    AU - Mandalakas, Anna

    AU - Maskew, Mhairi

    AU - Mofenson, Lynne

    AU - Mpoudi-Etame, Mireille

    AU - Okwara, Benson

    AU - Phiri, Sam

    AU - Wehbe, Firas

    AU - for the International Epidemiologic Databases to Evaluate AIDS (IeDEA)

    PY - 2015/1/1

    Y1 - 2015/1/1

    N2 - Background. 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 HIVinfected children remains a major challenge. Methods. 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. Results. 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. Conclusions. 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.

    AB - Background. 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 HIVinfected children remains a major challenge. Methods. 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. Results. 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. Conclusions. 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.

    KW - HIV

    KW - Low-income countries

    KW - Pediatric

    KW - Survey

    KW - Tuberculosis

    UR - http://www.scopus.com/inward/record.url?scp=85006201095&partnerID=8YFLogxK

    UR - http://www.scopus.com/inward/citedby.url?scp=85006201095&partnerID=8YFLogxK

    U2 - 10.1093/jpids/piu020

    DO - 10.1093/jpids/piu020

    M3 - Article

    C2 - 26407355

    AN - SCOPUS:85006201095

    VL - 4

    SP - 30

    EP - 38

    JO - Journal of the Pediatric Infectious Diseases Society

    JF - Journal of the Pediatric Infectious Diseases Society

    SN - 2048-7207

    IS - 1

    ER -