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Free Content Outcomes of HIV-infected children with tuberculosis who are started on antiretroviral therapy in Malawi

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Abstract:

SETTING: Mzuzu Central Hospital, in the northern region of Malawi, which provides free antiretroviral therapy (ART) to human immunodeficiency virus (HIV) infected adults and children, including those with tuberculosis (TB).

OBJECTIVES: To compare outcomes in HIV-infected children who have been started on ART because of 1) active TB, 2) a past history of TB in the last 2 years and 3) a non-TB diagnosis.

DESIGN: Retrospective data collection using ART patient master cards and ART patient registers.

RESULTS: Between July 2004 and September 2006, 439 (11%) children of a total 3908 patients were started on ART. There were 29 with active TB, 56 with a past history of TB in the last 2 years and 354 with a non-TB diagnosis. The three groups were similar in nutritional indices and CD4-lymphocyte percentages. The 6-month probability of survival was 0.86 in the active TB group, 0.94 in the past history of TB group and 0.89 in the non-TB group. 12-month survival probability for the same groups was 0.86, 0.86 and 0.88, respectively.

CONCLUSION: HIV-infected children with active and previous TB who are started on ART have good outcomes that are similar to those of children started on ART due to a non-TB diagnosis.

Keywords: Malawi; TB; antiretroviral therapy; children; treatment outcomes

Document Type: Regular Paper

Affiliations: 1: Taiwan Medical Mission, Mzuzu Central Hospital, Mzuzu, Malawi; International Medical Cooperation and Development Center, Pingtung Christian Hospital, Pingtung, Taiwan 2: International Medical Cooperation and Development Center, Pingtung Christian Hospital, Pingtung, Taiwan 3: Kaohsiung Medical University, Kaohsiung, Taiwan 4: Taiwan Medical Mission, Mzuzu Central Hospital, Mzuzu, Malawi 5: HIV Co-ordinator, Ministry of Health, Lilongwe, Malawi; and Management Sciences for Health, Lilongwe, Malawi 6: Management Sciences for Health, Lilongwe, Malawi 7: Taiwan Medical Mission, Mzuzu Central Hospital, Mzuzu, Malawi; International Medical Cooperation and Development Center, Pingtung Christian Hospital, Pingtung, Taiwan; Kaohsiung Medical University, Kaohsiung, Taiwan 8: Clinical HIV Unit, Ministry of Health, Lilongwe, Malawi; Family Health International, Malawi Country Office, Lilongwe, Malawi; London School of Hygiene and Tropical Medicine, Keppel Street, London, United Kingdom

Publication date: May 1, 2007

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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