Poor outcome is associated with delayed tuberculosis diagnosis in HIV-infected children in Baja California, Mexico.
OBJECTIVE
To describe the morbidity and mortality associated with tuberculosis (TB) in human immunodeficiency virus (HIV) infected children in Baja California, Mexico.


METHODS
Retrospective review of the medical records of all children with perinatally acquired HIV infection evaluated at Tijuana General Hospital with a diagnosis of TB between 1998 and 2007. The Stegen-Toledo (ST) clinical criteria for the diagnosis of TB were used.


RESULTS
A total of 73 HIV-infected children were followed during the study period. Thirteen (18%) children were diagnosed with TB; one was confirmed by culture to be positive. Among these children, the mean ages at HIV and TB diagnosis were respectively 3.6 and 5.3 years. The mean ST score was 8.1; 10/13 had a score of >or=7, or highly probable TB. There were a cumulative 29 hospital admissions prior to TB diagnosis; 24 of these were due to pneumonia. The mean duration of symptoms at TB diagnosis was 73 days. The most common symptoms were cough (92%) and anorexia (85%). Seven patients (54%) had disseminated TB and five (39%) died as a consequence of TB.


CONCLUSIONS
We observed high morbidity, hospital utilization and high mortality associated with TB among HIV-infected children in Baja California.
Viani
R M
RM
Department of Clinical Pediatrics, Division of Infectious Diseases, Center for AIDS Research, School of Medicine, University of California San Diego, San Diego, La Jolla, California 92093-0672, USA. rviani@ucsd.edu
Lopez
G
G
Chacón-Cruz
E
E
Hubbard
P
P
Spector
S A
SA
D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis* / Q000401:mortality*; D002675:Child, Preschool; D015658:HIV Infections / Q000150:complications* / Q000401:mortality; D006801:Humans; D008800:Mexico / Q000453:epidemiology; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification; D012189:Retrospective Studies; D013183:Sputum / Q000382:microbiology; D016896:Treatment Outcome; D014376:Tuberculosis / Q000175:diagnosis* / Q000401:mortality*