Tuberculosis Incidence among HIV Infected Children on HAART and their Clinical Profile, Retrospective Cohort Study, South West Ethiopia

Abstract

Background: Children aged below 15 years, carries almost 80% of the global burden of Human Immunodeficiency Virus. Sadly, Human Immunodeficiency Virus contribute for 50% of tuberculosis. In 2017, an estimated 1 million children became ill with TB and 230 000 children died of TB. Even though the use of HAART reduces TB incidence, wide Studies are showing opposing finding. Tuberculosis and Pneumonia are predominantly common among HIV infected children. Ethiopia is one of 22 the high TB burden country. The purpose of this study was to investigate the effect of highly active anti-retro viral therapy on the incidence of tuberculosis among children and their clinical profiles. Methods: A retrospective cohort study design was used on 800 HIV-positive Children younger than 15years old; from 2009 to 2014. Incidence rate was calculated by open Epi. Kaplan-Meier technique and the generalized log-rank test was used to construct and compare the tuberculosis-free survival probabilities for both Pre-HAART and HAART following children. Cox proportional hazards model was used to assess predictors of TB. Results: In HAART cohort the incidence of TB is (70) 3.59 per 100PYO at (2.8, 4.538 with 95% CI). In HAART naive (87) 4.63 per 100 PYO (3.705, 5.706 with 95% CI). The Kaplan Meir analysis for the overall comparison showed (log rank test statistic=1.029, DF=1, P=0.310). The predictors for TB incidence in this study are CD4 below threshold, gender being female and WHO clinical stage III or IV. Conclusion: Though the incidence in HAART cohort looks lower mathematically, there is no statistically significant difference. TB, Pneumonia, Diarrhea, and Dermatitis are the most clinically profiled opportunistic infections.