Childhood tuberculosis and human immunodeficiency virus status in Brazil: a hierarchical analysis

Int J Tuberc Lung Dis. 2015 Nov;19(11):1305-11. doi: 10.5588/ijtld.14.0619.

Abstract

Setting: Human immunodeficiency virus (HIV) infection may impact tuberculosis (TB) diagnosis, clinical presentation and treatment outcomes in children as the signs and symptoms of both diseases overlap.

Objective: To compare the sociodemographic and clinical profiles of childhood TB according to HIV status in Brazil.

Methods: This was a cross-sectional study of data on subjects aged <15 years retrieved from the Brazilian National Electronic Disease Registry (Sistema de Informação de Agravos de Notificação) database on TB to compare TB-HIV coinfected patients and patients with TB only registered between 2007 and 2011. A hierarchical logistic regression model was applied.

Results: Of 6091 cases analysed, 780 (12%) were TB-HIV patients, while 5311 (87%) presented with TB only. TB-HIV patients were more likely to be institutionalised (OR 2.22, 95%CI 1.43-3.46), to present with relapsed TB (OR 5.03, 95%CI 2.02-12.5) and be readmitted after treatment default (OR 16.7, 95%CI 4.34-64.46). They were also more likely to have unfavourable outcomes, including default (OR 2.85, 95%CI 1.81-4.49), death due to TB (OR 2.76, 95%CI 1.27-6.03) and death from other causes (OR 5.59, 95%CI 2.63-11.8).

Conclusion: Our study highlights the challenges of using national registers for research into childhood TB.

MeSH terms

  • Adolescent
  • Brazil / epidemiology
  • Child
  • Child Health
  • Child, Preschool
  • Coinfection / diagnosis
  • Coinfection / drug therapy
  • Coinfection / epidemiology*
  • Cross-Sectional Studies
  • Databases, Factual
  • Female
  • HIV Infections / diagnosis
  • HIV Infections / drug therapy
  • HIV Infections / epidemiology*
  • Humans
  • Infant
  • Infant, Newborn
  • Logistic Models
  • Male
  • Multivariate Analysis
  • Risk Factors
  • Treatment Outcome
  • Tuberculosis / diagnosis
  • Tuberculosis / drug therapy
  • Tuberculosis / epidemiology*