INCIDENCE, DETERMINANTS AND OUTCOMES OF LATENT AND ACTIVE TUBERCULOSIS AMONG HIV

HIV 感染者中潜伏性和活动性结核病的发病率、决定因素和结果

基本信息

批准号：
9029366
负责人：
Betty Kintu Nsangi
金额：
$ 4.86万
依托单位：
BAYLOR COLL OF MED CHILDREN'S FDN-UGANDA
依托单位国家：
美国
项目类别：
财政年份：
2013
资助国家：
美国
起止时间：
2013-04-18 至 2017-02-28
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9029366
关键词：
15 year old 5 year old Accounting Adolescent Adopted Adult Africa African Age Antitubercular Agents Attention Biological Assay Caring Cause of Death Child Child Mortality Childhood Clinic Clinical Cohort Studies Country Developing Countries Development Diagnosis Disease Early identification Formulation Future Goals Guidelines HIV HIV Seropositivity Health Immune Incidence Individual Infant Infection International Life Microscopy Monitor Morbidity - disease rate Newly Diagnosed Outcome Patients Policy Maker Population Prevalence Preventive therapy Prophylactic treatment Recommendation Recruitment Activity Reporting Research Risk Role Sputum Testing Treatment outcome Tuberculin Test Tuberculosis Uganda Work World Health Organization aged base case finding follow-up improved isoniazid lifetime risk mortality pediatric human immunodeficiency virus prevent programs prospective screening success transmission process tuberculosis treatment

项目摘要

DESCRIPTION (provided by applicant): It is estimated that children aged 0 - 14 years account for a third of all tuberculosis (TB) cases. It is reported that childhood TB contributes 15 - 40% o TB cases in developing countries but since unlike adult TB, childhood TB has not received a lot of attention, this estimate could be greater. TB is also the leading cause of death in HIV infected individuals. In 2010, there were 8.8 million newly diagnosed TB cases globally, of which 12 - 14% was HIV positive. Of the HIV positive TB cases, approximately 81% were from Africa. In Uganda, there were 70,000 newly diagnosed TB cases. Children get infected with TB from living in close contact with adults who have TB. However, the true burden of TB among children is not known. Further, the outcomes of TB treatment among children treated for active TB disease are not known. For instance the international treatment success rate (TSR) ranges from 70 - 85% whereas the Uganda treatment success rate (TSR) is 68%. However, the TSR for childhood TB is not known. It should be of concern whether children complete treatment, get cured or fail on treatment since children depend on adults for their care and they act as future reservoirs of TB disease. However, not much attention has been paid to them since they were believed not to contribute to the TB burden. The objective of this study therefore, is to determine the burden of latent and active TB and their treatment outcomes among HIV infected children in Uganda. This will be achieved through the following specific aims: 1) To determine the incidence of latent and active TB among children attending a pediatric HIV care facility in Kampala, Uganda; 2) To determine the treatment outcomes of children diagnosed with active TB and 3) To examine the clinical factors associated with development of active TB. We shall conduct a prospective cohort study in which we shall recruit and follow up HIV infected children. The children will be screened for latent and active TB using a revised intensified case finding form (RICF form), Tuberculin Skin Test (TST) and the T-SPOT(R).TB assay. Active TB will be diagnosed though x-rays, sputum microscopy and culture. They will be followed up for three years and monitored for TB development. Those diagnosed with TB will be followed up to study the treatment outcomes. It is expected that this study will yield information on the TB burden and treatment outcomes that will inform the National TB program on the burden of latent and active TB in HIV infected children. This may give an estimate of the burden of latent and active TB among HIV negative children. Use of the RICF alongside the TST and T- SPOT(R).TB will help in deciding whether the RICF can effectively identify TB suspects. Treatment of children with latent TB and general treatment of HIV-infected children with isoniazid will also provide essential information as the country prepares to adopt the new WHO Isoniazid Preventive Therapy (IPT) guidelines.

描述（由申请人提供）：据估计，0-14岁的儿童占所有结核病（TB）病例的三分之一。据报道，儿童结核病在发展中国家贡献了15-40％的O结核病病例，但由于与成人结核病不同，儿童结核病没有得到很大的关注，因此这种估计可能会更大。结核病也是感染艾滋病毒的主要原因个人。 2010年，全球有880万例新诊断的结核病病例，其中12-14％为HIV阳性。在HIV阳性病例中，大约81％来自非洲。在乌干达，有70,000例新诊断的结核病病例。儿童因与患有结核病的成年人密切接触而感染了结核病。但是，儿童中结核病的真正负担尚不清楚。此外，尚不清楚接受活性结核病疾病治疗的儿童结核病治疗的结果。例如，国际治疗成功率（TSR）的范围为70-85％，而乌干达治疗成功率（TSR）为68％。但是，儿童结核病的TSR尚不清楚。儿童是否完全治疗，治愈或无法治疗，因为儿童依靠成年人的护理，并且他们充当结核病疾病的未来水库，这应该引起人们的关注。但是，由于他们被认为没有为结核病负担做出贡献，因此对他们没有太多关注。因此，这项研究的目的是确定乌干达艾滋病毒感染儿童的潜在和主动结核病及其治疗结果的负担。这将通过以下特定目的来实现：1）确定参加乌干达坎帕拉儿科艾滋病毒护理设施的儿童中潜在和活跃结核病的发生率； 2）确定被诊断患有活性结核的儿童的治疗结果和3）检查与活性结核病发展相关的临床因素。我们将进行一项前瞻性队列研究，其中应在其中招募和跟进艾滋病毒感染的儿童。将使用修订后的加强病例查找形式（RICF形式），结核蛋白皮肤测试（TST）和T-SPOT（R）.TB分析对孩子进行潜在和主动结核病的筛查。通过X射线，痰液显微镜和培养，将诊断为活性结核。他们将进行三年的跟踪，并监视结核病开发。被诊断为结核病的人将被跟进以研究治疗结果。预计这项研究将产生有关结核病负担和治疗结果的信息，这些信息将为全国结核病计划提供有关艾滋病毒感染儿童潜在和活跃结核病负担的信息。这可能会估计艾滋病毒负面儿童中潜在和主动结核病负担。将RICF与TST和T-pote（R）.TB一起使用将有助于决定RICF是否可以有效地识别TB嫌疑犯。在该国准备采用新的WHO WHO WHO WHO WHO WHO WHO WHO WHO WHO WHO WHO WHO WHO WHO WHO WHO指南时，对ISONIAZID的艾滋病毒感染儿童的治疗以及对HIV感染儿童的一般治疗也将提供基本信息。