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接受抗逆转录病毒治疗儿童结核病发病的发展时间及预测因素

Time to Develop and Predictors for Incidence of Tuberculosis among Children Receiving Antiretroviral Therapy.

作者信息

Kebede Fassikaw, Kebede Tsehay, Kebede Birhanu, Abate Abebe, Jara Dube, Negese Belete, Shaweno Tamrat

机构信息

Woldia University, College of Health Science, School of Public Health, Department of Epidemiology & Biostatics, Ethiopia 2021.

Bahir Dare University, Faculty of Social Science, Department of Geography & Environmental Studies, Ethiopia 2021.

出版信息

Tuberc Res Treat. 2021 Nov 13;2021:6686019. doi: 10.1155/2021/6686019. eCollection 2021.

Abstract

Infection by the human immune deficiency virus (HIV) is the strongest risk factor for latent or new infection of tuberculosis (TB) through reduction of CD4 T-lymphocytes and cellular immune function. Almost one-third of deaths among people living with HIV are attributed to tuberculosis. Despite this evidence, in Ethiopia, there is a scarcity of information regarding the incidence of tuberculosis for children living with HIV. Thus, this study assessed time to develop and predictors for incidence of tuberculosis in children attending HIV/AIDS care in public hospitals: North West Ethiopia 2021. . A facility-based retrospective cohort study was conducted among 421 seropositive children on antiretroviral therapy in two hospitals between January 1, 2011 and December 31, 2020. EPI-DATA version 3.2 and STATA/14 software were used for data entry and analysis, respectively. Tuberculosis-free survival time was estimated using the Kaplan-Meier survival curve. Bivariate and multivariable Cox regression model was fitted to identify predictors at a value <0.05 within 95% CI. . In the final analysis, a total of 421 seropositive children were included, of whom, 64 (15.2%) developed tuberculosis at the time of follow-up. The mean (±SD) age of the children was 10.62 ± 3.32 years, with a median (IQR) time to develop TB that was 23.5 (IQR = ±19) months. This study found that the incidence of tuberculosis was 5.9 (95% CI: 4.7; 7.6) per 100 person-years (PY) risk of observation. Cases at baseline not taking cotrimoxazol preventive therapy (CPT) (AHR = 2.5; 95% CI, 1.4-4.7, < 0.021), being severely stunted (AHR = 2.9: 95% CI, 1.2-7.8, < 0.03), and having low hemoglobin level (AHR = 4.0; 95% CI, 2.1-8.1, < 0.001) were found to be predictors of tuberculosis. . A higher rate of tuberculosis incidence was reported in our study as compared with previous studies in Ethiopia. Cases at baseline not taking cotrimoxazol preventive therapy (CPT), being severely stunted, and having low hemoglobin (≤10 mg/dl) levels were found to be at higher risk to developed TB incidence.

摘要

人类免疫缺陷病毒(HIV)感染是导致结核病潜伏感染或新感染的最强风险因素,因为它会降低CD4 T淋巴细胞和细胞免疫功能。在感染HIV的人群中,近三分之一的死亡归因于结核病。尽管有这些证据,但在埃塞俄比亚,关于感染HIV儿童的结核病发病率的信息却很匮乏。因此,本研究评估了2021年埃塞俄比亚西北部公立医院接受HIV/AIDS护理的儿童患结核病的发病时间及预测因素。对2011年1月1日至2020年12月31日期间在两家医院接受抗逆转录病毒治疗的421名血清阳性儿童进行了一项基于机构的回顾性队列研究。分别使用EPI-DATA 3.2版软件和STATA/14软件进行数据录入和分析。使用Kaplan-Meier生存曲线估计无结核病生存时间。采用双变量和多变量Cox回归模型,在95%置信区间内以P值<0.05来确定预测因素。在最终分析中,共纳入421名血清阳性儿童,其中64名(15.2%)在随访期间患结核病。儿童的平均(±标准差)年龄为10.62±3.32岁,患结核病的中位(四分位间距)时间为23.5(四分位间距=±19)个月。本研究发现,结核病发病率为每100人年(PY)观察风险5.9例(95%置信区间:4.7;7.6)。基线时未接受复方新诺明预防性治疗(CPT)的病例(调整后风险比[AHR]=2.5;95%置信区间,1.4 - 4.7,P<0.021)、严重发育迟缓的病例(AHR = 2.9:95%置信区间,1.2 - 7.8,P<0.03)以及血红蛋白水平低的病例(AHR = 4.0;95%置信区间,2.1 - 8.1,P<0.001)被发现是结核病的预测因素。与埃塞俄比亚先前的研究相比,本研究报告的结核病发病率更高。基线时未接受复方新诺明预防性治疗(CPT)、严重发育迟缓以及血红蛋白水平低(≤10mg/dl)的病例被发现患结核病的风险更高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/762f/8605917/92ca5f9bb2c0/TRT2021-6686019.001.jpg

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