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For: Kapata N, Chanda-Kapata P, O'Grady J, Bates M, Mwaba P, Janssen S, Marais B, Cobelens F, Grobusch M, Zumla A. Trends in childhood tuberculosis in Zambia: a situation analysis. J Trop Pediatr 2013;59:134-9. [PMID: 23243079 DOI: 10.1093/tropej/fms065] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]

For:	Kapata N, Chanda-Kapata P, O'Grady J, Bates M, Mwaba P, Janssen S, Marais B, Cobelens F, Grobusch M, Zumla A. Trends in childhood tuberculosis in Zambia: a situation analysis. J Trop Pediatr 2013;59:134-9. [PMID: 23243079 DOI: 10.1093/tropej/fms065] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]

Number

Cited by Other Article(s)

du Preez K, Gabardo BMA, Kabra SK, Triasih R, Lestari T, Kal M, Tsogt B, Dorj G, Purev E, Nguyen TA, Naidoo L, Mvusi L, Schaaf HS, Hesseling AC, de Oliveira Rossoni AM, Carvalho ACC, Cardoso CAA, Sant’Anna CC, Orti DGD, Costa FD, Vega LR, Sant’Anna MDFP, Hoa NB, Phuc PH, Fiogbe AA, Affolabi D, Badoum G, Ouédraogo AR, Saouadogo T, Combary A, Kuate Kuate A, Prudence BNA, Magassouba AS, Bangoura AM, Soumana A, Hermana G, Gando H, Fall N, Gning B, Dogo MF, Mbitikon O, Deffense M, Zimba K, Chabala C, Sekadde MP, Luzze H, Turyahabwe S, Dongo JP, Lopes C, dos Santos M, Francis JR, Arango-Loboguerrero M, Perez-Velez CM, Koura KG, Graham SM. Priority Activities in Child and Adolescent Tuberculosis to Close the Policy-Practice Gap in Low- and Middle-Income Countries. Pathogens 2022;11:196. [PMID: 35215139 PMCID: PMC8878304 DOI: 10.3390/pathogens11020196] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 01/27/2022] [Accepted: 01/29/2022] [Indexed: 01/25/2023] Open

Affiliation(s)

Karen du Preez Desmond Tutu Tuberculosis Center, Department of Paediatrics and Child Health, Stellenbosch University, Cape Town 8000, South Africa; (H.S.S.); (A.C.H.)
Betina Mendez Alcântara Gabardo Pediatric Tuberculosis Working Group, Ministry of Health, Brasilia 70304-008, Brazil; (B.M.A.G.); (A.M.d.O.R.); (A.C.C.C.); (C.A.A.C.); (C.C.S.); (D.G.D.O.); (F.D.C.); (L.R.V.); (M.d.F.P.S.) Brazilian Network of Tuberculosis Research, REDE TB—Rede Brasileira de Pesquisas em Tuberculose, Rio de Janeiro 21941-909, Brazil
Sushil K. Kabra Department of Pediatrics, All India Institute of Medical Sciences, New Delhi 110029, India;
Rina Triasih Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta 55281, Indonesia; (R.T.); (T.L.)
Trisasi Lestari Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta 55281, Indonesia; (R.T.); (T.L.) Menzies School of Health Research, Charles Darwin University, Darwin, NT 0810, Australia;
Margaret Kal National Department of Health, Port Moresby 131, Papua New Guinea;
Bazarragchaa Tsogt Mongolian Coalition Against Tuberculosis, Ulaanbaatar 210648, Mongolia;
Gantsetseg Dorj Tuberculosis Surveillance and Research Department, National Center for Communicable Diseases, Ulaanbaatar 210648, Mongolia;
Enkhtsetseg Purev Tuberculosis Clinic, National Center for Communicable Diseases, Ulaanbaatar 210648, Mongolia;
Thu Anh Nguyen Woolcock Institute of Medical Research, Ha Noi 100000, Vietnam;
Lenny Naidoo Health Department, Cape Town 8000, South Africa;
Lindiwe Mvusi National TB Control & Management Cluster, National Department of Health, Pretoria 0187, South Africa;
Hendrik Simon Schaaf Desmond Tutu Tuberculosis Center, Department of Paediatrics and Child Health, Stellenbosch University, Cape Town 8000, South Africa; (H.S.S.); (A.C.H.)
Anneke C. Hesseling Desmond Tutu Tuberculosis Center, Department of Paediatrics and Child Health, Stellenbosch University, Cape Town 8000, South Africa; (H.S.S.); (A.C.H.)
Andrea Maciel de Oliveira Rossoni Pediatric Tuberculosis Working Group, Ministry of Health, Brasilia 70304-008, Brazil; (B.M.A.G.); (A.M.d.O.R.); (A.C.C.C.); (C.A.A.C.); (C.C.S.); (D.G.D.O.); (F.D.C.); (L.R.V.); (M.d.F.P.S.) Brazilian Network of Tuberculosis Research, REDE TB—Rede Brasileira de Pesquisas em Tuberculose, Rio de Janeiro 21941-909, Brazil
Anna Cristina Calçada Carvalho Pediatric Tuberculosis Working Group, Ministry of Health, Brasilia 70304-008, Brazil; (B.M.A.G.); (A.M.d.O.R.); (A.C.C.C.); (C.A.A.C.); (C.C.S.); (D.G.D.O.); (F.D.C.); (L.R.V.); (M.d.F.P.S.) Brazilian Network of Tuberculosis Research, REDE TB—Rede Brasileira de Pesquisas em Tuberculose, Rio de Janeiro 21941-909, Brazil Laboratory of Innovations in Therapies, Education and Bioproducts, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro 21045-900, Brazil
Claudete Aparecida Araújo Cardoso Pediatric Tuberculosis Working Group, Ministry of Health, Brasilia 70304-008, Brazil; (B.M.A.G.); (A.M.d.O.R.); (A.C.C.C.); (C.A.A.C.); (C.C.S.); (D.G.D.O.); (F.D.C.); (L.R.V.); (M.d.F.P.S.) Brazilian Network of Tuberculosis Research, REDE TB—Rede Brasileira de Pesquisas em Tuberculose, Rio de Janeiro 21941-909, Brazil
Clemax Couto Sant’Anna Pediatric Tuberculosis Working Group, Ministry of Health, Brasilia 70304-008, Brazil; (B.M.A.G.); (A.M.d.O.R.); (A.C.C.C.); (C.A.A.C.); (C.C.S.); (D.G.D.O.); (F.D.C.); (L.R.V.); (M.d.F.P.S.) Brazilian Network of Tuberculosis Research, REDE TB—Rede Brasileira de Pesquisas em Tuberculose, Rio de Janeiro 21941-909, Brazil
Danielle Gomes Dell’ Orti Pediatric Tuberculosis Working Group, Ministry of Health, Brasilia 70304-008, Brazil; (B.M.A.G.); (A.M.d.O.R.); (A.C.C.C.); (C.A.A.C.); (C.C.S.); (D.G.D.O.); (F.D.C.); (L.R.V.); (M.d.F.P.S.)
Fernanda Dockhorn Costa Pediatric Tuberculosis Working Group, Ministry of Health, Brasilia 70304-008, Brazil; (B.M.A.G.); (A.M.d.O.R.); (A.C.C.C.); (C.A.A.C.); (C.C.S.); (D.G.D.O.); (F.D.C.); (L.R.V.); (M.d.F.P.S.)
Liliana Romero Vega Pediatric Tuberculosis Working Group, Ministry of Health, Brasilia 70304-008, Brazil; (B.M.A.G.); (A.M.d.O.R.); (A.C.C.C.); (C.A.A.C.); (C.C.S.); (D.G.D.O.); (F.D.C.); (L.R.V.); (M.d.F.P.S.)
Maria de Fátima Pombo Sant’Anna Pediatric Tuberculosis Working Group, Ministry of Health, Brasilia 70304-008, Brazil; (B.M.A.G.); (A.M.d.O.R.); (A.C.C.C.); (C.A.A.C.); (C.C.S.); (D.G.D.O.); (F.D.C.); (L.R.V.); (M.d.F.P.S.) Brazilian Network of Tuberculosis Research, REDE TB—Rede Brasileira de Pesquisas em Tuberculose, Rio de Janeiro 21941-909, Brazil
Nguyen Binh Hoa National Tuberculosis Program, Ha Noi 100000, Vietnam;
Phan Huu Phuc National Pediatric Hospital, Ha Noi 100000, Vietnam;
Attannon Arnauld Fiogbe International Union Against Tuberculosis and Lung Disease, 75001 Paris, France; (A.A.F.); (G.B.); (A.R.O.); (A.C.); (A.K.K.); (A.S.M.); (A.S.); (G.H.); (N.F.); (M.F.D.); (O.M.); (M.D.); (K.G.K.); (S.M.G.) National Tuberculosis Program, Cotonou 03 BP 2819, Benin;
Dissou Affolabi National Tuberculosis Program, Cotonou 03 BP 2819, Benin; Faculty of Health Sciences, University of Abomey-Calavi, Cotonou 03 BP 2819, Benin
Gisèle Badoum International Union Against Tuberculosis and Lung Disease, 75001 Paris, France; (A.A.F.); (G.B.); (A.R.O.); (A.C.); (A.K.K.); (A.S.M.); (A.S.); (G.H.); (N.F.); (M.F.D.); (O.M.); (M.D.); (K.G.K.); (S.M.G.) Health Sciences Unit, University Joseph Ki-Zerbo, Ouagadougou 03 BP 7047, Burkina Faso Ministry of Health National Tuberculosis Program, Ouagadougou 03 BP 7047, Burkina Faso;
Abdoul Risgou Ouédraogo International Union Against Tuberculosis and Lung Disease, 75001 Paris, France; (A.A.F.); (G.B.); (A.R.O.); (A.C.); (A.K.K.); (A.S.M.); (A.S.); (G.H.); (N.F.); (M.F.D.); (O.M.); (M.D.); (K.G.K.); (S.M.G.) Health Sciences Unit, University Joseph Ki-Zerbo, Ouagadougou 03 BP 7047, Burkina Faso Ministry of Health National Tuberculosis Program, Ouagadougou 03 BP 7047, Burkina Faso;
Tandaogo Saouadogo Ministry of Health National Tuberculosis Program, Ouagadougou 03 BP 7047, Burkina Faso;
Adjima Combary International Union Against Tuberculosis and Lung Disease, 75001 Paris, France; (A.A.F.); (G.B.); (A.R.O.); (A.C.); (A.K.K.); (A.S.M.); (A.S.); (G.H.); (N.F.); (M.F.D.); (O.M.); (M.D.); (K.G.K.); (S.M.G.) National Tuberculosis Program, Yaoundé BP 6000, Cameroon;
Albert Kuate Kuate International Union Against Tuberculosis and Lung Disease, 75001 Paris, France; (A.A.F.); (G.B.); (A.R.O.); (A.C.); (A.K.K.); (A.S.M.); (A.S.); (G.H.); (N.F.); (M.F.D.); (O.M.); (M.D.); (K.G.K.); (S.M.G.) National Tuberculosis Program, Yaoundé BP 6000, Cameroon;
Bisso Ngono Annie Prudence National Tuberculosis Program, Yaoundé BP 6000, Cameroon;
Aboubakar Sidiki Magassouba International Union Against Tuberculosis and Lung Disease, 75001 Paris, France; (A.A.F.); (G.B.); (A.R.O.); (A.C.); (A.K.K.); (A.S.M.); (A.S.); (G.H.); (N.F.); (M.F.D.); (O.M.); (M.D.); (K.G.K.); (S.M.G.) National Tuberculosis Program, Conakry 63570, Guinea;
Adama Marie Bangoura National Tuberculosis Program, Conakry 63570, Guinea;
Alphazazi Soumana International Union Against Tuberculosis and Lung Disease, 75001 Paris, France; (A.A.F.); (G.B.); (A.R.O.); (A.C.); (A.K.K.); (A.S.M.); (A.S.); (G.H.); (N.F.); (M.F.D.); (O.M.); (M.D.); (K.G.K.); (S.M.G.) National Tuberculosis Program, Niamey 22 646, Niger
Georges Hermana International Union Against Tuberculosis and Lung Disease, 75001 Paris, France; (A.A.F.); (G.B.); (A.R.O.); (A.C.); (A.K.K.); (A.S.M.); (A.S.); (G.H.); (N.F.); (M.F.D.); (O.M.); (M.D.); (K.G.K.); (S.M.G.) National Tuberculosis Program, Bangui BP 729, Central African Republic;
Hervé Gando National Tuberculosis Program, Bangui BP 729, Central African Republic;
Nafissatou Fall International Union Against Tuberculosis and Lung Disease, 75001 Paris, France; (A.A.F.); (G.B.); (A.R.O.); (A.C.); (A.K.K.); (A.S.M.); (A.S.); (G.H.); (N.F.); (M.F.D.); (O.M.); (M.D.); (K.G.K.); (S.M.G.) National Tuberculosis Program, Dakar 12000, Senegal;
Barnabé Gning National Tuberculosis Program, Dakar 12000, Senegal;
Mohammed Fall Dogo International Union Against Tuberculosis and Lung Disease, 75001 Paris, France; (A.A.F.); (G.B.); (A.R.O.); (A.C.); (A.K.K.); (A.S.M.); (A.S.); (G.H.); (N.F.); (M.F.D.); (O.M.); (M.D.); (K.G.K.); (S.M.G.) National Tuberculosis Program, Lomé BP 526, Togo
Olivia Mbitikon International Union Against Tuberculosis and Lung Disease, 75001 Paris, France; (A.A.F.); (G.B.); (A.R.O.); (A.C.); (A.K.K.); (A.S.M.); (A.S.); (G.H.); (N.F.); (M.F.D.); (O.M.); (M.D.); (K.G.K.); (S.M.G.) National Tuberculosis Program, Bangui BP 729, Central African Republic;
Manon Deffense International Union Against Tuberculosis and Lung Disease, 75001 Paris, France; (A.A.F.); (G.B.); (A.R.O.); (A.C.); (A.K.K.); (A.S.M.); (A.S.); (G.H.); (N.F.); (M.F.D.); (O.M.); (M.D.); (K.G.K.); (S.M.G.)
Kevin Zimba Lusaka Provincial Health Office, Ministry of Health, Lusaka 10101, Zambia;
Chishala Chabala Department of Pediatrics and Child Health, School of Medicine, University of Zambia, Lusaka 10101, Zambia; Children’s Hospital, University Teaching Hospitals, Lusaka 10101, Zambia
Moorine Penninah Sekadde National Tuberculosis and Leprosy Program, Kampala 7025, Uganda; (M.P.S.); (H.L.); (S.T.)
Henry Luzze National Tuberculosis and Leprosy Program, Kampala 7025, Uganda; (M.P.S.); (H.L.); (S.T.)
Stavia Turyahabwe National Tuberculosis and Leprosy Program, Kampala 7025, Uganda; (M.P.S.); (H.L.); (S.T.)
John Paul Dongo The Union Uganda Office, Kampala 7025, Uganda;
Constantino Lopes National Tuberculosis Program, Ministerio da Saude, Dili NM 87109, Timor-Leste;
Milena dos Santos Hospital Nacional Guido Valadares, Ministerio da Saude, Dili NM 87109, Timor-Leste;
Joshua Reginald Francis Menzies School of Health Research, Charles Darwin University, Darwin, NT 0810, Australia;
Magnolia Arango-Loboguerrero Colombian Association of Pediatric Pulmonology, National University of Colombia, Bogota 500001, Colombia;
Carlos M. Perez-Velez Division of Infectious Diseases, University of Arizona College of Medicine, Tucson, AZ 85721, USA;
Kobto Ghislain Koura International Union Against Tuberculosis and Lung Disease, 75001 Paris, France; (A.A.F.); (G.B.); (A.R.O.); (A.C.); (A.K.K.); (A.S.M.); (A.S.); (G.H.); (N.F.); (M.F.D.); (O.M.); (M.D.); (K.G.K.); (S.M.G.) COMUE Sorbonne Paris Cité, Faculté des Sciences Pharmaceutiques et Biologiques, Université Paris Descartes, 75006 Paris, France École Nationale de Formation des Techniciens Supérieurs en Santé Publique et en Surveillance Epidémiologique, Université de Parakou, Parakou 03 BP 351, Benin
Stephen M. Graham International Union Against Tuberculosis and Lung Disease, 75001 Paris, France; (A.A.F.); (G.B.); (A.R.O.); (A.C.); (A.K.K.); (A.S.M.); (A.S.); (G.H.); (N.F.); (M.F.D.); (O.M.); (M.D.); (K.G.K.); (S.M.G.) Department of Pediatrics, Murdoch Childrens Research Institute, University of Melbourne Royal Children’s Hospital, Melbourne, VIC 3052, Australia

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Ben Ayed H, Gargouri L, Koubaa M, Rekik K, Hammemi F, Ben Jemaa M, Ben Hmida M, Mahfoudh A, Damak J, Ben Jemaa M. The growing burden of childhood tuberculosis in Southern Tunisia: temporal trends across two decades: 1995-2016. ELECTRONIC JOURNAL OF GENERAL MEDICINE 2019. [DOI: 10.29333/ejgm/109660] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]

Earley M, Chirenda J, Highet A, Mujuru HA, Yang Z. Characterizing Pediatric Tuberculosis with and without Human Immunodeficiency Virus Coinfection in Harare, Zimbabwe. Am J Trop Med Hyg 2018;99:601-607. [PMID: 30014829 DOI: 10.4269/ajtmh.18-0025] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open

Mwangwa F, Chamie G, Kwarisiima D, Ayieko J, Owaraganise A, Ruel TD, Plenty A, Tram KH, Clark TD, Cohen CR, Bukusi EA, Petersen M, Kamya MR, Charlebois ED, Havlir DV, Marquez C. Gaps in the Child Tuberculosis Care Cascade in 32 Rural Communities in Uganda and Kenya. J Clin Tuberc Other Mycobact Dis 2017;9:24-29. [PMID: 29291251 PMCID: PMC5743212 DOI: 10.1016/j.jctube.2017.10.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2017] [Revised: 10/11/2017] [Accepted: 10/24/2017] [Indexed: 11/28/2022] Open

Abstract

BACKGROUND

Reducing tuberculosis (TB) deaths among children requires a better understanding of the gaps in the care cascade from TB diagnosis to treatment completion. We sought to assess the child TB care cascade in 32 rural communities in Uganda and Kenya using programmatic data.

METHODS

This is a retrospective cohort study of 160,851 children (ages <15 years) living in 12 rural communities in Kenya and 22 in Uganda. We reviewed national TB registries from health centers in and adjacent to the 32 communities, and we included all child TB cases recorded from January 1, 2013 to June 30, 2016. To calculate the first step of the child TB care cascade, the number of children with active TB, we divided the number of reported child TB diagnoses by the 2015 World Health Organization (WHO) child TB case detection ratio for Africa of 27%. The remaining components of the Child TB Care Cascade were ascertained directly from the TB registries and included: diagnosed with TB, started on TB treatment, and completed TB treatment.

RESULTS

In two and a half years, a total of 42 TB cases were reported among children living in 32 rural communities in Uganda and Kenya. 40% of the children were co-infected with HIV. Using the WHO child TB case detection ratio, we calculated that 155 children in this cohort had TB during the study period. Of those 155 children, 42 were diagnosed and linked to TB care, 42 were started on treatment, and 31 completed treatment. Among the 42 children who started TB treatment, reasons for treatment non-completion were loss to follow up (7%), death (5%), and un-recorded reasons (5%). Overall, 20% (31/155) of children completed the child TB care cascade.

CONCLUSION

In 32 rural communities in Uganda and Kenya, we estimate that 80% of children with TB fell off the care cascade. Reducing morbidity and mortality from child TB requires strengthening of the child TB care cascade from diagnosis through treatment completion.

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Affiliation(s)

Florence Mwangwa Infectious Diseases Research Collaboration, Kampala, Uganda
Gabriel Chamie University of California, San Francisco, Division of HIV, Infectious Diseases and Global Medicine, Zuckerberg San Francisco General Hospital, San Francisco, USA
Dalsone Kwarisiima Infectious Diseases Research Collaboration, Kampala, Uganda Makerere University Joint AIDS Program, Kampala, Uganda Makerere University College of Health Sciences, School of Medicine, Kampala, Uganda
James Ayieko Kenya Medical Research Institute (KEMRI), Nairobi, Kenya
Asiphas Owaraganise Infectious Diseases Research Collaboration, Kampala, Uganda
Theodore D. Ruel University of California, San Francisco, Division Pediatric Infectious Diseases and Global Medicine, Department of Pediatrics, San Francisco, USA
Albert Plenty University of California, San Francisco, Division of HIV, Infectious Diseases and Global Medicine, Zuckerberg San Francisco General Hospital, San Francisco, USA
Khai Hoan Tram Stanford University, School of Medicine, Palo Alto, CA, USA
Tamara D. Clark University of California, San Francisco, Division of HIV, Infectious Diseases and Global Medicine, Zuckerberg San Francisco General Hospital, San Francisco, USA
Craig R. Cohen University of California, San Francisco, Department of Obstetrics and Gynecology, San Francisco, USA
Elizabeth A. Bukusi Kenya Medical Research Institute (KEMRI), Nairobi, Kenya
Maya Petersen University of California, Berkeley School of Public Health, Berkeley, United States
Moses R. Kamya Infectious Diseases Research Collaboration, Kampala, Uganda Makerere University College of Health Sciences, School of Medicine, Kampala, Uganda
Edwin D. Charlebois Center for AIDS Prevention Studies, University of California, San Francisco, United States
Diane V. Havlir University of California, San Francisco, Division of HIV, Infectious Diseases and Global Medicine, Zuckerberg San Francisco General Hospital, San Francisco, USA
Carina Marquez University of California, San Francisco, Division of HIV, Infectious Diseases and Global Medicine, Zuckerberg San Francisco General Hospital, San Francisco, USA

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Bates M, Shibemba A, Mudenda V, Chimoga C, Tembo J, Kabwe M, Chilufya M, Hoelscher M, Maeurer M, Sinyangwe S, Mwaba P, Kapata N, Zumla A. Burden of respiratory tract infections at post mortem in Zambian children. BMC Med 2016;14:99. [PMID: 27363601 PMCID: PMC4929772 DOI: 10.1186/s12916-016-0645-z] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Accepted: 06/14/2016] [Indexed: 12/22/2022] Open

Affiliation(s)

Matthew Bates HerpeZ, University Teaching Hospital, Lusaka, Zambia. .,University of Zambia and University College London Medical School (UNZA-UCLMS) Research and Training Programme, University Teaching Hospital, Lusaka, Zambia. .,Department of Infection, Division of Infection and Immunity, University College London, and NIHR Biomedical Research centre at UCL Hospitals, London, UK.
Aaron Shibemba Department of Pathology & Microbiology, University Teaching Hospital, Lusaka, Zambia
Victor Mudenda Department of Pathology & Microbiology, University Teaching Hospital, Lusaka, Zambia
Charles Chimoga HerpeZ, University Teaching Hospital, Lusaka, Zambia.,University of Zambia and University College London Medical School (UNZA-UCLMS) Research and Training Programme, University Teaching Hospital, Lusaka, Zambia
John Tembo HerpeZ, University Teaching Hospital, Lusaka, Zambia.,University of Zambia and University College London Medical School (UNZA-UCLMS) Research and Training Programme, University Teaching Hospital, Lusaka, Zambia.,Institute for Infectious Diseases, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
Mwila Kabwe HerpeZ, University Teaching Hospital, Lusaka, Zambia.,University of Zambia and University College London Medical School (UNZA-UCLMS) Research and Training Programme, University Teaching Hospital, Lusaka, Zambia
Moses Chilufya HerpeZ, University Teaching Hospital, Lusaka, Zambia.,University of Zambia and University College London Medical School (UNZA-UCLMS) Research and Training Programme, University Teaching Hospital, Lusaka, Zambia
Michael Hoelscher Division of Infectious Diseases and Tropical Medicine, Medical Centre of the University of Munich, Munich, Germany
Markus Maeurer Therapeutic Immunology, Department of Laboratory Medicine, Department of Microbiology, and Department of Tumour and Cell Biology, Karolinska Institute, Stockholm, Sweden
Sylvester Sinyangwe Department of Paediatrics & Child Health, University Teaching Hospital, Lusaka, Zambia
Peter Mwaba University of Zambia and University College London Medical School (UNZA-UCLMS) Research and Training Programme, University Teaching Hospital, Lusaka, Zambia.,Ministry of Health, Lusaka, Zambia
Nathan Kapata University of Zambia and University College London Medical School (UNZA-UCLMS) Research and Training Programme, University Teaching Hospital, Lusaka, Zambia.,National Tuberculosis Control Programme, Ministry of Community Development, Maternal and Child Health, Lusaka, Zambia
Alimuddin Zumla University of Zambia and University College London Medical School (UNZA-UCLMS) Research and Training Programme, University Teaching Hospital, Lusaka, Zambia.,Department of Infection, Division of Infection and Immunity, University College London, and NIHR Biomedical Research centre at UCL Hospitals, London, UK

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Kapata N, Chanda-Kapata P, Ngosa W, Metitiri M, Klinkenberg E, Kalisvaart N, Sunkutu V, Shibemba A, Chabala C, Chongwe G, Tembo M, Mulenga L, Mbulo G, Katemangwe P, Sakala S, Chizema-Kawesha E, Masiye F, Sinyangwe G, Onozaki I, Mwaba P, Chikamata D, Zumla A, Grobusch MP. The Prevalence of Tuberculosis in Zambia: Results from the First National TB Prevalence Survey, 2013-2014. PLoS One 2016;11:e0146392. [PMID: 26771588 PMCID: PMC4714873 DOI: 10.1371/journal.pone.0146392] [Citation(s) in RCA: 65] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Accepted: 12/16/2015] [Indexed: 11/30/2022] Open

Abstract

Background

Tuberculosis in Zambia is a major public health problem, however the country does not have reliable baseline data on the TB prevalence for impact measurement; therefore it was among the priority countries identified by the World Health Organization to conduct a national TB prevalence survey

Objective

To estimate the prevalence of tuberculosis among the adult Zambian population aged 15 years and above, in 2013–2014.

Methods

A cross-sectional population-based survey was conducted in 66 clusters across all the 10 provinces of Zambia. Eligible participants aged 15 years and above were screened for TB symptoms, had a chest x-ray (CXR) performed and were offered an HIV test. Participants with TB symptoms and/or CXR abnormality underwent an in-depth interview and submitted one spot- and one morning sputum sample for smear microscopy and liquid culture. Digital data collection methods were used throughout the process.

Results

Of the 98,458 individuals who were enumerated, 54,830 (55.7%) were eligible to participate, and 46,099 (84.1%) participated. Of those who participated, 45,633/46,099 (99%) were screened by both symptom assessment and chest x-ray, while 466/46,099 (1.01%) were screened by interview only. 6,708 (14.6%) were eligible to submit sputum and 6,154/6,708 (91.7%) of them submitted at least one specimen for examination. MTB cases identified were 265/6,123 (4.3%). The estimated national adult prevalence of smear, culture and bacteriologically confirmed TB was 319/100,000 (232-406/100,000); 568/100,000 (440-697/100,000); and 638/100,000 (502-774/100,000) population, respectively. The risk of having TB was five times higher in the HIV positive than HIV negative individuals. The TB prevalence for all forms was estimated to be 455 /100,000 population for all age groups.

Conclusion

The prevalence of tuberculosis in Zambia was higher than previously estimated. Innovative approaches are required to accelerate the control of TB.

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Affiliation(s)

Nathan Kapata National TB and Leprosy Control Program, Lusaka, Zambia Centre for Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands * E-mail:
Pascalina Chanda-Kapata Ministry of Health Headquarters, Lusaka, Zambia Centre for Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
William Ngosa Ministry of Health Headquarters, Lusaka, Zambia
Mine Metitiri Ministry of Health Headquarters, Lusaka, Zambia
Eveline Klinkenberg KNCV Tuberculosis Foundation, The Hague, the Netherlands Department of Global Health, Academic Medical Centre, University of Amsterdam, Amsterdam Institute for Global Health and Development, Amsterdam, The Netherlands
Nico Kalisvaart KNCV Tuberculosis Foundation, The Hague, the Netherlands
Veronica Sunkutu University Teaching Hospital, Lusaka, Zambia
Aaron Shibemba University Teaching Hospital, Lusaka, Zambia
Chishala Chabala University Teaching Hospital, Lusaka, Zambia
Gershom Chongwe Department of Public Health, University of Zambia, Lusaka, Zambia
Mathias Tembo Tropical Diseases Research Centre, Ndola, Zambia
Lutinala Mulenga Chest Diseases Laboratory, Ministry of Health, Lusaka, Zambia
Grace Mbulo University Teaching Hospital, Lusaka, Zambia
Patrick Katemangwe University Teaching Hospital, Lusaka, Zambia
Sandra Sakala Ministry of Health Headquarters, Lusaka, Zambia
Elizabeth Chizema-Kawesha Ministry of Health Headquarters, Lusaka, Zambia
Felix Masiye Department of Economics, School of Humanities and Social Sciences, University of Zambia, Lusaka, Zambia
George Sinyangwe United States Agency for International Development, Country Mission, Lusaka, Zambia
Ikushi Onozaki Global Tuberculosis Programme, World Health Organisation, Geneva, Switzerland
Peter Mwaba Ministry of Home Affairs headquarters, Lusaka, Zambia
Davy Chikamata Ministry of Health Headquarters, Lusaka, Zambia
Alimuddin Zumla Division of Infection and Immunity, Department of Infection, University College London, London, United Kingdom
Martin P. Grobusch Centre for Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands

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Wobudeya E, Lukoye D, Lubega IR, Mugabe F, Sekadde M, Musoke P. Epidemiology of tuberculosis in children in Kampala district, Uganda, 2009-2010; a retrospective cross-sectional study. BMC Public Health 2015;15:967. [PMID: 26407719 PMCID: PMC4582927 DOI: 10.1186/s12889-015-2312-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Accepted: 09/22/2015] [Indexed: 12/02/2022] Open

Abstract

Background

The global tuberculosis (TB) estimate in 2011 was 500,000 cases among children under 15 years representing 5.7 % of all cases and 64, 000 deaths among HIV negative children representing 6.5 % of the total deaths. In Uganda, the child TB cases reported in 2012 made up less than 3 % of the total cases while recent modelling estimates it at 15–20 % of adult cases. Mapping of these cases in Kampala district most especially for the children under five years would reflect recent transmission in the various communities in the district. We therefore conducted a retrospective study of reported child TB cases in Kampala district Uganda for 2009–2010 to provide an estimate of child TB incidence and map the cases.

Methods

This was a retrospective cross-sectional study on data collected from the health unit TB registers in the five divisions of Kampala district, Uganda. The data was a starting point in preparation for a TB Vaccine study in children. The extracted data spanned a period from 1st January 2009 to 31st December 2010. The projected population of children below 15 years was 637,922 in 2009 and 744,750 in 2010 for Kampala district. We based our projections on the National Bureau of Statistics most recent census report of 2002 before the study duration while assuming a population growth rate of 3.7 % each year. We captured the data into EPI DATA 3.1 and analysed it using STATA version 12.

Results

We accessed 15,499 records and analysed 1167 records that were of children below 15 years old. The child TB cases represented 7.5 % (7.3 in 2009 & 7.6 % in 2010) of all the registered cases in Kampala district. The females were 47 % and the median age was 4 years (IQR 1, 10). The percent of children less than 5 years old was 54 %. The percent of pulmonary TB cases was 89 % (1041/1167) with 15 % smear positive. The proportion of extra-pulmonary TB cases was 11 % (126/1167). Among those that tested for HIV, 60 % (359/620) had test results available with an HIV co-infection rate of 47 % (168/359). Antiretroviral treatment uptake was 24 % among the co-infected. The incidence of child TB in Kampala was 56 (95 % CI 50–62) per 100,000 in 2009 and 44 (95 % CI 40–49) per 100,000 in 2010. Most of the TB cases (60 % (410/685)) in Kampala live in slum areas.

Conclusion

There was a higher child TB incidence of 56 per 100,000 in 2009 compared with 44 per 100,000 in 2010. The percentage of child TB cases was much higher at 7.5 % of all the reported TB cases than the WHO reported national average. For the review period, the TB cases clustered in particular slums in Kampala district.

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Incidence of Tuberculosis Among Young Children in Rural Mozambique. Pediatr Infect Dis J 2015;34:686-92. [PMID: 26069945 DOI: 10.1097/inf.0000000000000710] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]

Cremers AL, de Laat MM, Kapata N, Gerrets R, Klipstein-Grobusch K, Grobusch MP. Assessing the consequences of stigma for tuberculosis patients in urban Zambia. PLoS One 2015;10:e0119861. [PMID: 25806955 PMCID: PMC4373828 DOI: 10.1371/journal.pone.0119861] [Citation(s) in RCA: 109] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2014] [Accepted: 01/17/2015] [Indexed: 11/21/2022] Open

Abstract

BACKGROUND

Stigma is one of the many factors hindering tuberculosis (TB) control by negatively affecting hospital delay and treatment compliance. In Zambia, the morbidity and mortality due to TB remains high, despite extended public health attempts to control the epidemic and to diminish stigma.

STUDY AIM

To enhance understanding of TB-related stigmatizing perceptions and to describe TB patients' experiences of stigma in order to point out recommendations to improve TB policy.

METHODS

We conducted a mixed method study at Kanyama clinic and surrounding areas, in Lusaka, Zambia; structured interviews with 300 TB patients, multiple in-depth interviews with 30 TB patients and 10 biomedical health workers, 3 focus group discussions with TB patients and treatment supporters, complemented by participant observation and policy analysis of the TB control program. Predictors of stigma were identified by use of multivariate regression analyses; qualitative analysis of the in-depth interviews, focus group discussions and participant observation was used for triangulation of the study findings.

RESULTS

We focused on the 138/300 patients that described TB-related perceptions and attitudes, of whom 113 (82%) reported stigma. Stigma provoking TB conceptions were associated with human immunodeficiency virus (HIV)-infection, alleged immoral behaviour, (perceived) incurability, and (traditional) myths about TB aetiology. Consequences of stigma prevailed both among children and adults and included low self-esteem, insults, ridicule, discrimination, social exclusion, and isolation leading to a decreased quality of life and social status, non-disclosure, and/or difficulties with treatment compliance and adherence. Women had significantly more stigma-related problems than men.

CONCLUSIONS

The findings illustrate that many TB patients faced stigma-related issues, often hindering effective TB control and suggesting that current efforts to reduce stigma are not yet optimal. The content and implementation of sensitization programs should be improved and more emphasis needs to be placed on women and children.

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Chatterjee D, Pramanik AK. Tuberculosis in the African continent: A comprehensive review. ACTA ACUST UNITED AC 2015;22:73-83. [PMID: 25620557 DOI: 10.1016/j.pathophys.2014.12.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2014] [Revised: 12/27/2014] [Accepted: 12/30/2014] [Indexed: 02/01/2023]

Jenkins HE, Tolman AW, Yuen CM, Parr JB, Keshavjee S, Pérez-Vélez CM, Pagano M, Becerra MC, Cohen T. Incidence of multidrug-resistant tuberculosis disease in children: systematic review and global estimates. Lancet 2014;383:1572-9. [PMID: 24671080 PMCID: PMC4094366 DOI: 10.1016/s0140-6736(14)60195-1] [Citation(s) in RCA: 225] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]

Abstract

BACKGROUND

Multidrug-resistant tuberculosis threatens to reverse recent reductions in global tuberculosis incidence. Although children younger than 15 years constitute more than 25% of the worldwide population, the global incidence of multidrug-resistant tuberculosis disease in children has never been quantified. We aimed to estimate the regional and global annual incidence of multidrug-resistant tuberculosis in children.

METHODS

We developed two models: one to estimate the setting-specific risk of multidrug-resistant tuberculosis among child cases of tuberculosis, and a second to estimate the setting-specific incidence of tuberculosis disease in children. The model for risk of multidrug-resistant tuberculosis among children with tuberculosis needed a systematic literature review. We multiplied the setting-specific estimates of multidrug-resistant tuberculosis risk and tuberculosis incidence to estimate regional and global incidence of multidrug-resistant tuberculosis disease in children in 2010.

FINDINGS

We identified 3403 papers, of which 97 studies met inclusion criteria for the systematic review of risk of multidrug-resistant tuberculosis. 31 studies reported the risk of multidrug-resistant tuberculosis in both children and treatment-naive adults with tuberculosis and were used for evaluation of the linear association between multidrug-resistant disease risk in these two patient groups. We identified that the setting-specific risk of multidrug-resistant tuberculosis was nearly identical in children and treatment-naive adults with tuberculosis, consistent with the assertion that multidrug-resistant disease in both groups reflects the local risk of transmitted multidrug-resistant tuberculosis. After application of these calculated risks, we estimated that around 999,792 (95% CI 937,877-1,055,414) children developed tuberculosis disease in 2010, of whom 31,948 (25,594-38,663) had multidrug-resistant disease.

INTERPRETATION

Our estimates underscore that many cases of tuberculosis and multidrug-resistant tuberculosis disease are not being detected in children. Future estimates can be refined as more and better tuberculosis data and new diagnostic instruments become available.

FUNDING

US National Institutes of Health, the Helmut Wolfgang Schumann Fellowship in Preventive Medicine at Harvard Medical School, the Norman E Zinberg Fellowship at Harvard Medical School, and the Doris and Howard Hiatt Residency in Global Health Equity and Internal Medicine at the Brigham and Women's Hospital.

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