title: Seroprevalence of human immunodeficiency virus type 1 infection in Zambian children with tuberculosis.
abstract: Descriptions in the medical literature of human immunodeficiency virus type 1 (HIV-1) in children with tuberculosis (TB) are scanty. This study determined the seroprevalence of HIV-1 in 237 hospitalized children between the ages of 1 month and 14 years with a clinical diagnosis of TB (125 males and 112 females) and in 242 control children (149 males and 93 females). The overall HIV-1 seroprevalence rate in patients with TB was 37% (88 of 237) compared with 10.7% (26 of 242) among the control group (P < 0.00001: odds ratio 5.37, 95% confidence interval = 3.21 < 5.37 < 9.47). HIV-1 seropositivity in children with TB ranged from 53% (31 of 58) in the 12- to 18-month age group to 14% (9 of 61) in the 10- to 14-year-olds. The risk of TB attributable to HIV infection was 29%. The predominant clinical presentation in both seronegative (84.6%) and seropositive (89.7%) groups was that of pulmonary TB and there were no significant differences in clinical presentation between the two groups of patients. Only 54.8% of the patients attended follow-up clinics regularly whereas 32% were lost to follow-up within 3 months. Bacillus Calmette-Guérin vaccination coverage was 87.3% among TB patients and 90.5% in the controls. No significant differences in B. Calmette-Guérin vaccination rates between the seronegative and seropositive children were seen. Coinfection with HIV and TB in children is now one of the major public health problems in Zambian children.
authors.affiliation: Department of Paediatrics, University Teaching Hospital, Lusaka, Zambia.
authors.forename: C
authors.initials: C
authors.lastname: Chintu
authors.forename: G
authors.initials: G
authors.lastname: Bhat
authors.forename: C
authors.initials: C
authors.lastname: Luo
authors.forename: M
authors.initials: M
authors.lastname: Raviglione
authors.forename: V
authors.initials: V
authors.lastname: Diwan
authors.forename: H L
authors.initials: HL
authors.lastname: Dupont
authors.forename: A
authors.initials: A
authors.lastname: Zumla
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000453:epidemiology*; D000293:Adolescent; D001500:BCG Vaccine; D002648:Child; D002675:Child, Preschool; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006679:HIV Seropositivity / Q000150:complications / Q000453:epidemiology*; D015497:HIV-1 / Q000276:immunology*; D006801:Humans; D007223:Infant; D007538:Isoniazid / Q000627:therapeutic use; D008297:Male; D015995:Prevalence; D011446:Prospective Studies; D013307:Streptomycin / Q000627:therapeutic use; D013828:Thioacetazone / Q000627:therapeutic use; D016896:Treatment Outcome; D014376:Tuberculosis / Q000150:complications* / Q000188:drug therapy / Q000517:prevention & control; D015024:Zambia / Q000453:epidemiology
chemical_list: D001500:BCG Vaccine; D013828:Thioacetazone; D007538:Isoniazid; D013307:Streptomycin