Recently, pulmonary tuberculosis (PTB) incidence is a serious co-infection and an emerging global concern for children living with human immune deficiency virus (HIV). However, the incidence of PTB among adult HIV patients is exhaustively studied; the incidence of PTB among children on ART is overlooked. This research provides invaluable time based relevant actionsclues.
Objective:- Hospital-based retrospective cohort study was conducted among 359 HIV infected children those registered on ART since 2009-2018. Time to develop PTB defined as the time from enrollment for ART care until the development of PTB. The proportional hazard assumption was checked for each variable and no variable was found with Schoenfeld test <0.05. Variables with P-value <0.25 at bivariate Cox regression analysis were entered into the multivariable Cox model. Multivariable Cox regression model with 95%CI and AHR used to identify significant predictor.
Result:-Totally 359 HIV infected children followed and produced 686.5 Person per Years of observation (PYOs) with minimum and maximum follow up time on ART was 0.34 & 5.1 years, respectively. The median age of the children was 9 (SD±3.78) years. The overall incidence density of PTB was 7.2 Person/100years in 95%CI (5.52--- 9.24).Notably being age group >= 11 years (AHR=5.1 95% CI 1.4--18.), who stage 3&4 (AHR= 3.4 times increase the risks of PTB developed was compared WHO clinical stage 1& 2 (AHR=3.4 95%CI: 1.2-9.7). Being sever underweight (AHR=3.2 95%CI: 1.3--7.8), not started INHAHR =2.8, 95%CI: 1.1 -7.2) and having previous opportunistic infections (AHR= 2.34 95%CI: 1.3--4.1) significantly associated with PTB incidence.
Conclusion:-The incidence of PTB in HIV infected children were found higher as compared with evidence from previous findings. Strengthening intensified screening of INH and therapeutic feeding needs for risk children highly recommended.