Browsing by Author "Rambiki E"

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    Tuberculosis diagnosis, treatment, and prevention services for children living with HIV in low- and middle-income countries: a multiregional site survey.
    (2025-May-28) Laycock K; Technau KG; Lelo P; Jantarabenjakul W; Yonaba C; Pinto J; Menser M; Maruri F; Odhiambo F; Rambiki E; Babakazo P; Van Lam N; Folquet M; Machado DM; Kalema N; Muula G; Brazier E; Dinh Qui N; Dame J; Luque MT; Semeere A; Eley B; Yotebieng M; Kariminia A; Rouzier V; Byakwaga H; Marcy O; Enane LA; Lighthouse Clinic Trust, Lilongwe, Malawi.; The Kirby Institute, UNSW Sydney, Australia.; Kalembelembe Pediatric Hospital, Unit of Infectious Diseases, Kinshasa, Democratic Republic of Congo.; CHU Cocody, Service Pédiatrie, Abidjan, Côte d'Ivoire.; Center of Excellence for Pediatric Infectious Diseases and Vaccines, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.; Red Cross War Memorial Children's Hospital and the Department of Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa.; Pediatric Department, Centre Hospitalier Universitaire Yalgado Ouédraogo, Ouagadougou, Burkina Faso.; Infectious Diseases Department, Children's Hospital 2, Ho Chi Minh City, Vietnam.; Infectious Diseases Institute, College of Health Sciences, Makerere University, Kampala, Uganda.; Kinshasa School of Public Health, Democratic Republic of Congo.; Empilweni Services and Research Unit (ESRU), Rahima Moosa Mother and Child Hospital, Department of Paediatrics and Child Health, Faculty of Health Sciences, University of The Witwatersrand, Johannesburg, South Africa.; University of Ghana Medical School and Korle Bu Teaching Hospital, Accra Ghana.; Center for Infectious Disease Research in Zambia, Lusaka, Zambia.; Instituto Hondureño de Seguridad Social, Tegucigalpa, Honduras.; Indiana University Department of Biostatistics and Health Data Science, Indianapolis, United States.; Indiana University Center for Global Health Equity, Indianapolis, United States.; The Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, United States.; Center for Tropical Diseases, Vietnam National Children's Hospital, Hanoi, Vietnam.; Federal University of Minas Gerais, Belo Horizonte, Brazil.; City University of New York, Institute for Implementation Science in Population Health, New York, United States.; Division of General Internal Medicine, Department of Medicine, Albert Einstein College of Medicine, The Bronx, New York, United States.; Mbarara University of Science and Technology, Mbarara, Uganda.; Family AIDS Care and Education Services, Kenya Medical Research Institute, Kisumu, Kenya.; University of Bordeaux, Inserm U1219 Bordeaux Population Health, IRD EMR271 GHiGS, Bordeaux, France.; Division of Infectious Diseases, Vanderbilt University School of Medicine, Nashville, United States.; Les Centres GHESKIO, Port-au-Prince, Haiti.; Escola Paulista de Medicina - Federal University of São Paulo (EPM-UNIFESP), São Paulo, Brazil.; CIDRZ; Centre for Infectious Disease Research in Zambia (CIDRZ)
    BACKGROUND: Tuberculosis (TB) remains a leading cause of morbidity and mortality for children living with HIV (CLHIV), with gaps in TB screening, diagnostics, management, and TB preventive therapy (TPT). We investigated reported practices in these domains at sites caring for CLHIV in low- and middle-income countries (LMICs) within the International epidemiology Databases to Evaluate AIDS (IeDEA) consortium. METHODS: We implemented a site survey during September 2020-February 2021, querying pre-pandemic practices. This analysis included sites in LMICs providing care for CLHIV that diagnosed TB in 2019. We analyzed responses using descriptive statistics and assessed regional differences using Fisher's exact or chi-square tests. RESULTS: Of 238 IeDEA sites, 227 (95%) responded and 135 met inclusion criteria. Most (90%) reported screening for TB at HIV care enrollment. Access to diagnostics varied significantly by region, including for nucleic acid amplification testing (NAAT, range 67-100%), mycobacterial culture (range 43-83%), and drug susceptibility testing (range 30-82%) (p<0.001). On-site TB treatment was high (90%). Reported stock-outs occurred for isoniazid (23/116, 20%) and other TB medications (11/114, 9.6%, range 0-33%, p=0.008). TPT provision ranged 50-100% (p<0.001). Six months of isoniazid was the most common TPT regimen for children (88%). Shorter TPT regimens were uncommon (0.9-2.8%), as were regimens for multidrug-resistant TB exposure (4.6%). CONCLUSIONS: Overall reported availability of NAAT and integrated TB/HIV treatment for CLHIV cared for at these IeDEA sites in LMICs is encouraging but varies by context. Heterogeneous implementation gaps remain-particularly for drug susceptibility testing, TPT delivery and TPT regimens-which successful outcomes for CLHIV, warranting continued close attention over time and as global TB care guidelines and services evolve.