Tuberculosis Infection in Early Childhood and the Association with HIV-exposure in HIV-uninfected Children in Rural Uganda. Issue 5 (May 2016)

• Record Type: Journal Article
• Authors: Marquez, Carina; Chamie, Gabriel; Achan, Jane; Luetkemeyer, Anne F.; Kyohere, Mary; Okiring, Jaffer; Dorsey, Grant; Kamya, Moses R.; Charlebois, Edwin D.; Havlir, Diane V.
• Is Part Of: Pediatric infectious disease journal. Volume 35:Issue 5(2016)
• Publication Date: 2016-05
• Subjects: childhood TB infection -- latent TB infection -- HIV-exposed children; Communicable diseases in children -- Periodicals; Infection in children -- Periodicals; 618.929
• DOI: 10.1097/INF.0000000000001062
• Languages: English
• ISSNs: 0891-3668

Abstract

Abstract : Background: In high tuberculosis (TB) burden countries, a significant proportion of the latent TB reservoir is established by the age 5 years. There are critical knowledge gaps in our understanding of the age-specific prevalence of TB infection and the influence of HIV exposure on TB infection in the first 5 years of life among HIV-uninfected children in sub-Saharan Africa. Methods: We measured TB infection with the Quantiferon Gold-in-Tube (QFT) and tuberculin skin tests (TST) in 447 children ⩽60 months and their 284 HIV-infected and IV-uninfected mothers in rural Uganda. Results: The overall prevalence of TB infection in children ⩽60 months by TST was 24% (95% confidence intervals [CI]: 19.9–27.9). The prevalence of TST positivity was highest among children in their first year of life (36%; 95% CI: 26.0–45.9) and declined with age to 19% at 36–60 months of age, χ 2 test for trend P = 0.014. In contrast, 4% (95% CI: 1.9–5.87%) of children had a positive QFT, and there was no trend detected with age, P = 0.576. QFT positivity was detected as early as 5 months. HIV-exposed uninfected children had significantly higher odds of TB infection by QFT (odds ratio [OR]: 21.2; P = 0.008; 95% CI: 2.2–204.7) or positive TST or QFT (OR, 2.4; P = 0.020; 95% CI: 1.2–5.1) compared with HIV-unexposed uninfected children, adjusting for age, BCG vaccination and a positive maternal TST or QFT. Conclusions: An appreciable prevalence of TB infection was detected in early childhood. HIV-exposed uninfected children have a higher risk for TB infection compared with children born to HIV-uninfected mothers. Abstract : Supplemental Digital Content is available in the text.