title: Childhood tuberculosis and human immunodeficiency virus status in Brazil: a hierarchical analysis.
abstract: METHODS
  Human immunodeficiency virus (HIV) infection may impact tuberculosis (TB) diagnosis, clinical presentation and treatment outcomes in children as the signs and symptoms of both diseases overlap.
  
  
  OBJECTIVE
  To compare the sociodemographic and clinical profiles of childhood TB according to HIV status in Brazil.
  
  
  METHODS
  This was a cross-sectional study of data on subjects aged <15 years retrieved from the Brazilian National Electronic Disease Registry (Sistema de Informação de Agravos de Notificação) database on TB to compare TB-HIV coinfected patients and patients with TB only registered between 2007 and 2011. A hierarchical logistic regression model was applied.
  
  
  RESULTS
  Of 6091 cases analysed, 780 (12%) were TB-HIV patients, while 5311 (87%) presented with TB only. TB-HIV patients were more likely to be institutionalised (OR 2.22, 95%CI 1.43-3.46), to present with relapsed TB (OR 5.03, 95%CI 2.02-12.5) and be readmitted after treatment default (OR 16.7, 95%CI 4.34-64.46). They were also more likely to have unfavourable outcomes, including default (OR 2.85, 95%CI 1.81-4.49), death due to TB (OR 2.76, 95%CI 1.27-6.03) and death from other causes (OR 5.59, 95%CI 2.63-11.8).
  
  
  CONCLUSIONS
  Our study highlights the challenges of using national registers for research into childhood TB.
authors.affiliation: Laboratory of Epidemiology, Federal University of Espírito Santo, Vitória, Espírito Santo, Rio de Janeiro, Brazil; School of Nursing, Federal University of Espírito Santo, Vitória, Espírito Santo, Rio de Janeiro, Brazil.
authors.forename: E
authors.initials: E
authors.lastname: dos Santos Dias
authors.affiliation: Laboratory of Epidemiology, Federal University of Espírito Santo, Vitória, Espírito Santo, Rio de Janeiro, Brazil; School of Nursing, Federal University of Espírito Santo, Vitória, Espírito Santo, Rio de Janeiro, Brazil; Post-Graduate Programme in Infectious Diseases, Federal University of Espírito Santo, Vitória, Espírito Santo, Brazil.
authors.forename: T N
authors.initials: TN
authors.lastname: do Prado
authors.affiliation: Laboratory of Epidemiology, Federal University of Espírito Santo, Vitória, Espírito Santo, Rio de Janeiro, Brazil; School of Nursing, Federal University of Espírito Santo, Vitória, Espírito Santo, Rio de Janeiro, Brazil.
authors.forename: A L
authors.initials: AL
authors.lastname: da Silva Guimarães
authors.affiliation: School of Nursing, Federal University of Espírito Santo, Vitória, Espírito Santo, Rio de Janeiro, Brazil.
authors.forename: M C
authors.initials: MC
authors.lastname: Ramos
authors.affiliation: Laboratory of Epidemiology, Federal University of Espírito Santo, Vitória, Espírito Santo, Rio de Janeiro, Brazil; School of Nursing, Federal University of Espírito Santo, Vitória, Espírito Santo, Rio de Janeiro, Brazil; Post-Graduate Programme in Infectious Diseases, Federal University of Espírito Santo, Vitória, Espírito Santo, Brazil.
authors.forename: C M M
authors.initials: CM
authors.lastname: Sales
authors.affiliation: School of Nursing, Federal University of Espírito Santo, Vitória, Espírito Santo, Rio de Janeiro, Brazil.
authors.forename: E
authors.initials: E
authors.lastname: de Fátima Almeida Lima
authors.affiliation: Faculty of Medicine<sup>, </sup> Federal University of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil.
authors.forename: C C
authors.initials: CC
authors.lastname: Sant'Anna
authors.affiliation: Department of Public Health, University of Brasilia, Brasilia DF, Brazil.
authors.forename: M
authors.initials: M
authors.lastname: Sanchez
authors.affiliation: Laboratory of Epidemiology, Federal University of Espírito Santo, Vitória, Espírito Santo, Rio de Janeiro, Brazil; School of Nursing, Federal University of Espírito Santo, Vitória, Espírito Santo, Rio de Janeiro, Brazil; Post-Graduate Programme in Infectious Diseases, Federal University of Espírito Santo, Vitória, Espírito Santo, Brazil; Post-Graduate Program in Public Health, Federal University of Espírito Santo, Vitória, Espírito Santo, Brazil.
authors.forename: E L
authors.initials: EL
authors.lastname: Maciel
mesh_terms: D000293:Adolescent; D001938:Brazil / Q000453:epidemiology; D002648:Child; D000067576:Child Health; D002675:Child, Preschool; D060085:Coinfection / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D016208:Databases, Factual; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D012307:Risk Factors; D016896:Treatment Outcome; D014376:Tuberculosis / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*