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Childhood tuberculosis and human immunodeficiency virus status in Brazil: a hierarchical analysis
E dos Santos Dias1, T N do Prado2, A L da Silva Guimarães1
1Laboratory 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.
Setting:
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).
Conclusion:
Our study highlights the challenges of using national registers for research into childhood TB.
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