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 Bashi & 31 others William 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.",
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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

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

U2 - 10.1093/jpids/piu020

DO - 10.1093/jpids/piu020

M3 - Article

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 -