title: High Incidence of Tuberculosis in the Absence of Isoniazid and Cotrimoxazole Preventive Therapy in Children Living with HIV in Northern Ethiopia: A Retrospective Follow-Up Study.
abstract: OBJECTIVE
  To identify the incidence of and predictors for tuberculosis in children living with HIV in Northern Ethiopia.
  
  
  METHODS
  Observational, retrospective follow-up study.
  
  
  METHODS
  A total of 645 HIV-infected children were observed between September 2009 and September 2014. Cox regression analysis was used to identify predictors for developing TB.
  
  
  RESULTS
  The incidence rate of tuberculosis was 4.2 per 100 child-years. Incidence of tuberculosis was higher for subjects who were not on cotrimoxazole preventive therapy, were not on isoniazid preventive therapy, had delayed motor development, had a CD4 cell count below the threshold, had hemoglobin level less than 10 mg/dl and were assessed as World Health Organization (WHO) clinical stage III or IV.
  
  
  CONCLUSIONS
  Incidence of TB in children living with HIV was high. This study reaffirmed that isoniazid preventive therapy is one of the best strategy to reduce incidence of TB in children living with HIV. All children living with HIV should be screened for TB but for children with delayed motor development, advanced WHO clinical stage, anemia or immune suppression, intensified screening is highly recommended.
authors.affiliation: School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia.
authors.forename: Yihun Mulugeta
authors.initials: YM
authors.lastname: Alemu
authors.affiliation: Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
authors.forename: Gashaw
authors.initials: G
authors.lastname: Andargie
authors.affiliation: Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
authors.forename: Ejigu
authors.initials: E
authors.lastname: Gebeye
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000453:epidemiology* / Q000517:prevention & control; D000293:Adolescent; D000995:Antitubercular Agents / Q000008:administration & dosage; D002648:Child; D002675:Child, Preschool; D005002:Ethiopia / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007538:Isoniazid / Q000008:administration & dosage; D053208:Kaplan-Meier Estimate; D008297:Male; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000008:administration & dosage; D014397:Tuberculosis, Pulmonary / Q000150:complications* / Q000453:epidemiology* / Q000517:prevention & control
chemical_list: D000995:Antitubercular Agents; D015662:Trimethoprim, Sulfamethoxazole Drug Combination; D007538:Isoniazid