Tuberculosis among children and adolescents at HIV treatment centers in Sub-Saharan Africa

Academic Article


  • HIV-infected children and adolescents are at increased risk for tuberculosis (TB). Antiretroviral therapy (ART) reduces TB risk in HIV-infected adults, but its effectiveness in HIV-infected children and adolescents is unknown. We analyzed data from 7 integrated pediatric HIV/TB centers in 6 countries in sub-Saharan Africa. We used a Bayesian mixed-effect model to assess association between ART and TB prevalence and used adaptive lasso regression to analyze risk factors for adverse TB outcomes. The study period encompassed 57,525 patient-years and 1,160 TB cases (2,017 cases/100,000 patient-years). Every 10% increase in ART uptake resulted in a 2.33% reduction in TB prevalence. Favorable TB outcomes were associated with increased time in care and early ART initiation, whereas severe immunosuppression was associated with death. These findings support integrated HIV/TB services for HIV-infected children and adults and demonstrate the association of ART uptake with decreased TB incidence in high HIV/TB settings.
  • Digital Object Identifier (doi)

    Author List

  • Mandalakas AM; Kay AW; Bacha JM; Devezin T; Golin R; Simon KR; Dhillon D; Dlamini S; DiNardo A; Matshaba M
  • Start Page

  • 2933
  • End Page

  • 2943
  • Volume

  • 26
  • Issue

  • 12