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Yield of screening for TB and HIV among children failing to thrive in Botswana
Tonya Arscott-Mills1, Ari Ho-Foster, Margaret Lowenstein
1Botswana-UPenn Partnership, Gaborone, Botswana.
Insights
Tuberculosis (TB) screening in children with failure to thrive (FTT) diagnosed TB in 6% of cases. Human immunodeficiency virus (HIV) screening did not identify new infections in this vulnerable population.
Area of Science:
- Pediatrics
- Infectious Diseases
- Public Health
Background:
- Failure to thrive (FTT) is a significant indicator of potential tuberculosis (TB) and human immunodeficiency virus (HIV) infection in children.
- Assessing the prevalence of TB and HIV in children experiencing FTT is crucial for early diagnosis and intervention.
Purpose of the Study:
- To evaluate the prevalence of TB and HIV among children presenting with FTT at a clinic in Botswana.
- To determine the effectiveness of screening protocols for these infections in a pediatric FTT cohort.
Main Methods:
- A prospective screening of 919 children attending a 'Well Child' clinic was conducted in July 2010.
- Children diagnosed with FTT were referred for comprehensive pediatric evaluation, including specific assessments for TB and HIV.
- Data on TB and HIV evaluations and diagnoses were collected through patient chart reviews and direct assessments.
Main Results:
- Out of 919 children screened, 176 (19%) exhibited FTT.
- TB evaluation was completed by 95 children, resulting in a new TB diagnosis in 6 (6%).
- Of 118 children with known HIV status, 23 (19%) had their status known; 45 tested for HIV, all with negative results. 95 children had unknown HIV status.
Conclusions:
- TB screening in children with FTT successfully identified new cases, with 6% diagnosed upon completing evaluation.
- Current screening protocols did not detect new HIV infections within the studied FTT pediatric population.
- The study highlights the importance of systematic TB and HIV screening in children with FTT.
Background:
Failure to thrive (FTT) is a sign of tuberculosis (TB) and human immunodeficiency virus (HIV) infection. We assessed TB and HIV prevalence in children with FTT at one clinic in Botswana.
Methods:
In July 2010, we screened all children attending a 'Well Child' clinic for FTT. Children with FTT were referred to a paediatrician who: (i) assessed causes of FTT, (ii) evaluated for HIV and TB and (iii) reviewed the patient chart for evaluations for TB and HIV.
Results:
Of 919 children screened, 176 (19%) had FTT. One hundred eighteen (67%) children saw a paediatrician, and of these, 95 (81%) completed the TB evaluation. TB was newly diagnosed in 6 of 95 (6%). At review, HIV status was known in 23 of 118 (19%). Ninety-five had an unknown HIV status. Forty-five (47%) tested for HIV; all tested HIV-negative.
Conclusion:
TB and HIV screening among children with FTT diagnosed TB in 6% of cases completing an evaluation, but no new HIV infections.
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