L A Enane1, E D Lowenthal2, T Arscott-Mills3, M Matlhare4, L S Smallcomb5, B Kgwaadira6, S E Coffin7, A P Steenhoff1. 1. Division of Infectious Diseases, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA; Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA; Botswana-UPenn Partnership, Gaborone, Botswana. 2. Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA; Botswana-UPenn Partnership, Gaborone, Botswana, Center for Clinical Epidemiology & Biostatistics, University of Pennsylvania, Philadelphia, Pennsylvania, USA. 3. Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA; Botswana-UPenn Partnership, Gaborone, Botswana. 4. Botswana-UPenn Partnership, Gaborone, Botswana. 5. Division of Infectious Diseases, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA. 6. Botswana National TB Programme, Ministry of Health, Gaborone, Botswana. 7. Division of Infectious Diseases and, Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
Abstract
SETTING: Nine high-burden public tuberculosis (TB) clinics in Gaborone, Botswana. OBJECTIVE: To describe clinical characteristics and outcomes among adolescents with TB and compare loss to follow-up (LTFU) rates with that among youth and adult cases. DESIGN: Retrospective cohort study of TB cases registered from 2012 to 2014. Clinical characteristics and treatment outcomes were compared among adolescents (age 10-19 years), youth (20-24 years) and a systematic sample of adults (⩾25 years). RESULTS: We analyzed 120 adolescent, 210 youth, and 548 adult cases. Adolescents had twice the risk of LTFU over adults (RR 2.0, 95%CI 1.1-3.7, P = 0.03), and higher LTFU than youth; this was not significant (RR 1.4, 95%CI 0.7-2.9, P = 0.32). Of those with human immunodeficiency virus (HIV) infection, 8/35 (22.9%) adolescents were LTFU, compared with 3/51 (5.9%) youth, and 25/407 (6.1%) adults (P = 0.001). In a multivariable model, adolescence (OR 3.0, 95%CI 1.3-6.5, P < 0.01), HIV positivity (OR 2.2, 95%CI 1.1-4.5, P = 0.02), and extra-pulmonary TB (OR 2.2, 95%CI 1.2-4.0, P = 0.01) were each associated with LTFU. CONCLUSION: Adolescents treated for TB had greater LTFU than youth and adults, particularly in the setting of TB-HIV coinfection. Further work should clarify the generalizability of these findings and investigate poor outcomes among adolescents with TB.
SETTING: Nine high-burden public tuberculosis (TB) clinics in Gaborone, Botswana. OBJECTIVE: To describe clinical characteristics and outcomes among adolescents with TB and compare loss to follow-up (LTFU) rates with that among youth and adult cases. DESIGN: Retrospective cohort study of TB cases registered from 2012 to 2014. Clinical characteristics and treatment outcomes were compared among adolescents (age 10-19 years), youth (20-24 years) and a systematic sample of adults (⩾25 years). RESULTS: We analyzed 120 adolescent, 210 youth, and 548 adult cases. Adolescents had twice the risk of LTFU over adults (RR 2.0, 95%CI 1.1-3.7, P = 0.03), and higher LTFU than youth; this was not significant (RR 1.4, 95%CI 0.7-2.9, P = 0.32). Of those with human immunodeficiency virus (HIV) infection, 8/35 (22.9%) adolescents were LTFU, compared with 3/51 (5.9%) youth, and 25/407 (6.1%) adults (P = 0.001). In a multivariable model, adolescence (OR 3.0, 95%CI 1.3-6.5, P < 0.01), HIV positivity (OR 2.2, 95%CI 1.1-4.5, P = 0.02), and extra-pulmonary TB (OR 2.2, 95%CI 1.2-4.0, P = 0.01) were each associated with LTFU. CONCLUSION: Adolescents treated for TB had greater LTFU than youth and adults, particularly in the setting of TB-HIV coinfection. Further work should clarify the generalizability of these findings and investigate poor outcomes among adolescents with TB.
Authors: Leslie A Enane; Elizabeth D Lowenthal; Tonya Arscott-Mills; Jessica Eby; Cynthia Caiphus; Botshelo Kgwaadira; Susan E Coffin; Andrew P Steenhoff Journal: Pediatr Infect Dis J Date: 2019-10 Impact factor: 2.129
Authors: R T Ncube; K C Takarinda; C Zishiri; W van den Boogaard; N Mlilo; C Chiteve; N Siziba; F Trinchán; C Sandy Journal: Public Health Action Date: 2017-09-21
Authors: L A Enane; J Eby; T Arscott-Mills; S Argabright; C Caiphus; B Kgwaadira; A P Steenhoff; E D Lowenthal Journal: Int J Tuberc Lung Dis Date: 2020-02-01 Impact factor: 2.373
Authors: L K Reif; V Rivera; R Bertrand; V Rouzier; E Kutscher; K Walsh; B Charles; J W Pape; D W Fitzgerald; S P Koenig; M L McNairy Journal: Public Health Action Date: 2018-09-21
Authors: Kathryn J Snow; Lisa J Nelson; Charalambos Sismanidis; Susan M Sawyer; Stephen M Graham Journal: Epidemiol Infect Date: 2018-04-15 Impact factor: 4.434
Authors: K M Laycock; J Eby; T Arscott-Mills; S Argabright; C Caiphus; B Kgwaadira; E D Lowenthal; A P Steenhoff; L A Enane Journal: Int J Tuberc Lung Dis Date: 2021-07-01 Impact factor: 3.427
Authors: Marcia C B de Oliveira; Clemax C Sant'Anna; Ronir Raggio Luiz; Afrânio L Kritski Journal: Am J Trop Med Hyg Date: 2020-09-17 Impact factor: 3.707
Authors: Kathryn J Snow; Andrea T Cruz; James A Seddon; Rashida A Ferrand; Silvia S Chiang; Jennifer A Hughes; Beate Kampmann; Steve M Graham; Peter J Dodd; Rein M Houben; Justin T Denholm; Susan M Sawyer; Katharina Kranzer Journal: Lancet Child Adolesc Health Date: 2019-11-18