title: Microbiological investigation for tuberculosis among HIV-infected children in Soweto, South Africa.
abstract: METHODS
  A paediatric human immunodeficiency virus (HIV) clinic in an academic hospital in Soweto, South Africa.
  
  
  OBJECTIVE
  1) To describe and compare the clinical, immunological and virological characteristics of HIV-infected children co-treated for tuberculosis (TB), and 2) to compare those investigated microbiologically with those who were not, with a description of the results of the microbiological TB investigation.
  
  
  METHODS
  Retrospective analysis of TB-HIV-infected children aged <15 years treated for TB between 1 October 2007 and 15 March 2009.
  
  
  RESULTS
  Anti-tuberculosis treatment was initiated in 616/3358 (18%) children during the study period. Microbiological TB investigation results were available for 399/616 (65%), among whom culture-confirmed TB was diagnosed in 49 (12%). Drug susceptibility testing was performed in 29/49 (59%) children: 5/29 (17%) were isoniazid-resistant, and 3 had multidrug-resistant TB. Children aged >8 years and those between 3 and 8 years were more likely to have culture-confirmed TB than those aged <3 years (aOR 9.4, 95%CI 2.26-39.08 vs. aOR 6.7, 95%CI 1.60-27.69), as were those with CD4 count <200 cells/mm(3) compared to those with >500 cells/mm(3) (aOR 3.95, 95%CI 1.23-12.72).
  
  
  CONCLUSIONS
  Our study in HIV-infected children showed a high TB case rate, a low rate of definite TB and a high rate of drug-resistant TB based on World Health Organization case definitions. Increased uptake of available TB tests and availability of new diagnostic tests remains a priority in high TB-HIV burden settings.
authors.affiliation: Wits Reproductive Health & HIV Institute, School of Clinical Medicine, University of the Witwatersrand, Cape Town, South Africa.
authors.forename: L
authors.initials: L
authors.lastname: Fairlie
authors.affiliation: Wits Reproductive Health & HIV Institute, School of Clinical Medicine, University of the Witwatersrand, Cape Town, South Africa.
authors.forename: E
authors.initials: E
authors.lastname: Muchiri
authors.affiliation: National Health Laboratory Service, Mycobacteriology Referral Laboratory & Department of Clinical Microbiology & Infectious Diseases, University of the Witwatersrand, Cape Town, South Africa.
authors.forename: C N
authors.initials: CN
authors.lastname: Beylis
authors.affiliation: Harriet Shezi Children's Clinic, Department of Paediatrics, Chris Hani Baragwanath Hospital, Faculty of Health Sciences, University of the Witwatersrand, Cape Town, South Africa.
authors.forename: T
authors.initials: T
authors.lastname: Meyers
authors.affiliation: Wits Reproductive Health & HIV Institute, School of Clinical Medicine, University of the Witwatersrand, Cape Town, South Africa.
authors.forename: H
authors.initials: H
authors.lastname: Moultrie
mesh_terms: D000046:Academic Medical Centers; D000293:Adolescent; D000367:Age Factors; D000995:Antitubercular Agents / Q000627:therapeutic use*; D001431:Bacteriological Techniques; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D060085:Coinfection; D003430:Cross-Sectional Studies; D004359:Drug Therapy, Combination; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000453:epidemiology / Q000276:immunology / Q000821:virology; D006801:Humans; D007223:Infant; D016015:Logistic Models; D008297:Male; D008826:Microbial Sensitivity Tests; D015999:Multivariate Analysis; D009169:Mycobacterium tuberculosis / Q000187:drug effects / Q000276:immunology / Q000302:isolation & purification*; D016017:Odds Ratio; D010044:Outpatient Clinics, Hospital; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012307:Risk Factors; D013019:South Africa / Q000453:epidemiology; D013997:Time Factors; D014376:Tuberculosis / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology / Q000276:immunology / Q000382:microbiology; D018088:Tuberculosis, Multidrug-Resistant / Q000175:diagnosis / Q000382:microbiology
chemical_list: D000995:Antitubercular Agents