RESUMEN
SETTING: Centres participating in the Paediatric European Network for Treatment of AIDS (PENTA), including Thailand and Brazil. OBJECTIVE: To describe the incidence, presentation, treatment and treatment outcomes of tuberculosis (TB) in human immunodeficiency virus (HIV) infected children. DESIGN: Observational study of TB diagnosed in HIV-infected children in 2011-2013. RESULTS: Of 4265 children aged <16 years, 127 (3%) were diagnosed with TB: 6 (5%) in Western Europe, 80 (63%) in Eastern Europe, 27 (21%) in Thailand and 14 (11%) in Brazil, with estimated TB incidence rates of respectively 239, 982, 1633 and 2551 per 100 000 person-years (py). The majority (94%) had acquired HIV perinatally. The median age at TB diagnosis was 6.8 years (interquartile range 3.0-11.5). Over half (52%) had advanced/severe World Health Organization stage immunodeficiency; 67 (53%) were not on antiretroviral therapy (ART) at TB diagnosis. Preventive anti-tuberculosis treatment was given to 23% (n = 23) of 102 children diagnosed with HIV before TB. Eleven children had unfavourable TB outcomes: 4 died, 5 did not complete treatment, 1 had recurrent TB and 1 had an unknown outcome. In univariable analysis, previous diagnosis of acquired immune-deficiency syndrome, not being virologically suppressed on ART at TB diagnosis and region (Brazil) were significantly associated with unfavourable TB outcomes. CONCLUSION: Most TB cases were from countries with high TB prevalence. The majority (91%) had favourable outcomes. Universal ART and TB prophylaxis may reduce missed opportunities for TB prevention
Asunto(s)
Humanos , Niño , Tuberculosis , Niño , Infecciones Oportunistas Relacionadas con el SIDARESUMEN
SETTING: Centres participating in the Paediatric European Network for Treatment of AIDS (PENTA), including Thailand and Brazil. OBJECTIVE: To describe the incidence, presentation, treatment and treatment outcomes of tuberculosis (TB) in human immunodeficiency virus (HIV) infected children. DESIGN: Observational study of TB diagnosed in HIV-infected children in 2011-2013. RESULTS: Of 4265 children aged <16 years, 127 (3%) were diagnosed with TB: 6 (5%) in Western Europe, 80 (63%) in Eastern Europe, 27 (21%) in Thailand and 14 (11%) in Brazil, with estimated TB incidence rates of respectively 239, 982, 1633 and 2551 per 100 000 person-years (py). The majority (94%) had acquired HIV perinatally. The median age at TB diagnosis was 6.8 years (interquartile range 3.0-11.5). Over half (52%) had advanced/severe World Health Organization stage immunodeficiency; 67 (53%) were not on antiretroviral therapy (ART) at TB diagnosis. Preventive anti-tuberculosis treatment was given to 23% (n = 23) of 102 children diagnosed with HIV before TB. Eleven children had unfavourable TB outcomes: 4 died, 5 did not complete treatment, 1 had recurrent TB and 1 had an unknown outcome. In univariable analysis, previous diagnosis of acquired immune-deficiency syndrome, not being virologically suppressed on ART at TB diagnosis and region (Brazil) were significantly associated with unfavourable TB outcomes. CONCLUSION: Most TB cases were from countries with high TB prevalence. The majority (91%) had favourable outcomes. Universal ART and TB prophylaxis may reduce missed opportunities for TB prevention.
Asunto(s)
Profilaxis Antibiótica , Coinfección/epidemiología , Infecciones por VIH/epidemiología , Tuberculosis/epidemiología , Terapia Antirretroviral Altamente Activa , Antituberculosos/uso terapéutico , Índice de Masa Corporal , Brasil/epidemiología , Niño , Preescolar , Estudios de Cohortes , Coinfección/tratamiento farmacológico , Coinfección/prevención & control , Europa (Continente)/epidemiología , Femenino , Estudios de Seguimiento , Infecciones por VIH/tratamiento farmacológico , Humanos , Masculino , Prevalencia , Factores de Riesgo , Tailandia/epidemiología , Tuberculosis/diagnóstico , Tuberculosis/tratamiento farmacológico , Organización Mundial de la SaludRESUMEN
The objectives of this study were to determine the prevalence of scabies in an infested village; to educate the residents on self-treatment and prevention by the use of 5% monosulfiram soap; to evaluate the short term effectiveness of this intervention by determining, 2 weeks later, the compliance to self-treatment and prevention; and to determine the prevalence rate on the second visit. In 59 households (96.7% of the village) containing 313 persons, an educational session was held and a leaflet distributed on the use and availability of the soap. Thirteen persons (4.2%) from eight households (13.6%) had scabies. After 2 weeks, 7 persons (2.2%) (2 persisting and 5 new cases) from 5 households (8.5%) were infested. Thus a cure rate of 85% was obtained though the prevalence rate showed no statistically significant difference. Among the under 15 year olds, the numbers infected decreased from 10 to 3 while among the over 15 years olds, the numbers infected increased from 3 to 4, neither reading significance at the 5% level.
Asunto(s)
Escabiosis/prevención & control , Adolescente , Adulto , Factores de Edad , Anciano , Animales , Distribución de Chi-Cuadrado , Niño , Preescolar , Disulfiram/uso terapéutico , Femenino , Humanos , Lactante , Masculino , Persona de Mediana Edad , Cooperación del Paciente , Prevalencia , Escabiosis/epidemiología , Factores Sexuales , Jabones , Trinidad y Tobago/epidemiologíaRESUMEN
The objectives of this study were to determine the prevalence of scabies in an infested village; to educate the residents on self-treatment and prevention by the use of 5 percent monosulfiram soap; to evaluate the short term effectiveness of this intervention by determining, 2 weeks later, the compliance to self-treatment and prevention; and to determine the prevalence rate on the second visit. In 59 households (96.7 percent of the village) containing 313 persons, an educational session was held and a leaflet distributed on the use and availability of the soap. Thirteen persons (4.2 percent) from eight households (13.6 percent) had scabies. After 2 weeks, 7 persons (2.2 percent) (2 persiting and 5 new cases) from 5 households (8.5 percent) were infested. Thus a cure rate of 85 percent was obtained though the prevalence rate showed no statistically significant difference. Among the under 15 year olds, the numbers infected decreased from 10 to 3 while among the over 15 year olds, the numbers infected increased from 3 to 4, neither reading significance at the 5 percent level. (AU)
Asunto(s)
Humanos , Lactante , Preescolar , Niño , Adolescente , Adulto , Persona de Mediana Edad , Anciano , 21003 , Masculino , Femenino , Escabiosis/prevención & control , Factores de Edad , Distribución de Chi-Cuadrado , Disulfiram/uso terapéutico , Cooperación del Paciente , Prevalencia , Escabiosis/epidemiología , Factores Sexuales , Jabones , Trinidad y Tobago/epidemiologíaRESUMEN
During a school survey in May 1988, the Madras Government School in County Caroni had 13.8 percent scabies infection. The objectives of the present study were to determine the presence of scabies in the village of Madras, to educate the residents on self-treatment and prevention of scabies by the use of 5 percent monosulfiram soap, and to re-assess the village for scabies prevalence and compliance 2 weeks later. At each of the 59 (95.2 percent) households, every child present was physically examined for scabies as well as adults with a relevant symptomatic history. Hygenic conditions, overcrowding and the presence and absence of infected dogs and cats were noted. An educational session on the use of Tetmosol (5 percent monosulfiram) soap was conducted. At follow-up 2 weeks later, the presence of scabies was determined, information on compliance elicited and dogs and cats inspected. Three hundred and thirteen persons were examined of whom 84 percent were < 40 years of age with 17.4 percent in the 5-9 years age group. There were 13 persons with scabies (prevalence rate of 4.2 percent) in 8/59 households (13.6 percent). Seven of the eight households had 5 or more occupants and accounted for 12/13 cases of scabies. On the second visit, the number with scabies fell to 2 (reduction of 84.6 percent) but there were 5 new cases to give a prevalence rate of 2.3 percent. Five of the 59 households (8.5 percent) had scabies and 4 of them had 5 or more occupants. The study showed that scabies was more prevalent in the younger age group (5-9 years), was associated with overcrowding, was eliminated when Tetmosol soap was properly used but poor compliance by non-infected persons prevented a more significant reduction in the prevalence rate (AU)