背景:结核病是导致单一传染病死亡的主要原因之一,由结核分枝杆菌引起的.在埃塞俄比亚,尽管已经对感染艾滋病毒的儿童中结核病的发病率进行了几项初步研究,HIV感染儿童(0~14岁)的结核病合并发病率未知.因此,本系统综述和荟萃分析的主要目的是评估埃塞俄比亚HIV感染儿童中结核病的合并发病率及其预测因素.
方法:国际电子数据库,如PubMed、Hinari,科学直接,谷歌学者,和非洲期刊在线使用不同的搜索引擎进行搜索。使用JoannaBriggs研究所检查表检查主要研究的质量。使用I平方统计量检验研究的异质性。使用漏斗图和Egger测试测试发布偏差。森林地块和表格用于呈现结果。随机效应模型用于估计感染艾滋病毒的儿童中结核病的合并发病率。
结果:本系统综述和荟萃分析共纳入13项研究。每100人年观察,HIV感染儿童的结核病合并发病率为3.77(95%CI:2.83,5.02)。晚期HIV疾病(HR:2.72,95%CI:1.9;3.88),没有接受完整的疫苗接种(HR:4.40,95%CI:2.16;8.82),发育迟缓(HR:2.34,95%CI:1.64,3.33),体重不足(HR:2.30,95%CI:1.61;3.22),未接受异烟肼预防性治疗(HR:3.64,95%CI:2.22,5.96),贫血(HR:3.04,95%CI:2.34;3.98),一般或较差的抗逆转录病毒治疗依从性(HR:2.50,95%CI:1.84;3.40)和未接受复方新诺明预防性治疗(HR:3.20,95%CI:2.26;4.40)是HIV感染儿童合并结核感染的预测因子.
结论:本系统评价和荟萃分析得出的结论是,与ENDTB战略目标相比,埃塞俄比亚HIV感染儿童中结核病的总体合并发病率较高。因此,必须强调药物依从性(ART和异烟肼)和营养咨询。此外,营养不良和贫血的早期诊断和治疗对于降低结核合并感染的风险至关重要.
背景:在PROSPERO中注册,ID:CRD42023474956。
BACKGROUND: Tuberculosis is one the leading causes of death from a single infectious disease, caused by the bacillus mycobacterium tuberculosis. In Ethiopia, even though several primary studies have been conducted on the incidence of tuberculosis among HIV-infected children, the pooled incidence rate of tuberculosis among HIV-infected children (aged 0-14 years) is unknown. Therefore, the main objectives of this systematic
review and meta-analysis are to estimate the pooled incidence rate of tuberculosis among HIV-infected children and its predictors in Ethiopia.
METHODS: International electronic databases such as PubMed, HINARI, Science Direct, Google Scholar, and African Journals Online were searched using different search engines. Quality of primary studies was checked using the Joanna Briggs Institute checklist. The heterogeneity of studies was tested using I-square statistics. Publication bias was tested using a funnel plot and Egger\'s test. Forest plots and tables were used to present the results. The random effect model was used to estimate the pooled incidence of tuberculosis among children living with HIV.
RESULTS: A total of 13 studies were included in this systematic
review and meta-analysis. The pooled incidence of tuberculosis among HIV-infected children was 3.77 (95% CI: 2.83, 5.02) per 100-person-year observations. Advanced HIV disease (HR: 2.72, 95% CI: 1.9; 3.88), didn\'t receive complete vaccination (HR: 4.40, 95% CI: 2.16; 8.82), stunting (HR: 2.34, 95% CI: 1.64, 3.33), underweight (HR: 2.30, 95% CI: 1.61; 3.22), didn\'t receive Isoniazid preventive therapy (HR: 3.64, 95% CI: 2.22, 5.96), anemia (HR: 3.04, 95% CI: 2.34; 3.98), fair or poor antiretroviral therapy adherence (HR: 2.50, 95% CI: 1.84; 3.40) and didn\'t receive cotrimoxazole preventive therapy (HR: 3.20, 95% CI: 2.26; 4.40) were predictors of tuberculosis
coinfection among HIV infected children.
CONCLUSIONS: This systematic
review and meta-analysis concluded that the overall pooled incidence rate of tuberculosis among HIV-infected children was high in Ethiopia as compared to the END TB strategy targets. Therefore, emphasis has to be given to drug adherence (ART and Isoniazid) and nutritional counseling. Moreover, early diagnosis and treatment of malnutrition and anemia are critical to reduce the risk of TB
coinfection.
BACKGROUND: Registered in PROSPERO with ID: CRD42023474956.