scholarly journals HIV-Associated Tuberculosis in Children and Adolescents: Evolving Epidemiology, Screening, Prevention and Management Strategies

Pathogens ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. 33
Author(s):  
Alexander W. Kay ◽  
Helena Rabie ◽  
Elizabeth Maleche-Obimbo ◽  
Moorine Penninah Sekadde ◽  
Mark F. Cotton ◽  
...  
Keyword(s):  
Drug Interactions ◽  
Lung Disease ◽  
Children And Adolescents ◽  
Test Performance ◽  
Management Strategies ◽  
Age Groups ◽  
Treatment Strategies ◽  
Diagnostic Test Performance ◽  
Living With Hiv ◽  
Tuberculosis In Children

Children and adolescents living with HIV continue to be impacted disproportionately by tuberculosis as compared to peers without HIV. HIV can impact TB screening and diagnosis by altering screening and diagnostic test performance and can complicate prevention and treatment strategies due to drug–drug interactions. Post-tuberculosis lung disease is an underappreciated phenomenon in children and adolescents, but is more commonly observed in children and adolescents with HIV-associated tuberculosis. This review presents new data related to HIV-associated TB in children and adolescents. Data on the epidemiology of HIV-associated TB suggests that an elevated risk of TB in children and adolescents with HIV persists even with broad implementation of ART. Recent guidance also indicates the need for new screening strategies for HIV-associated TB. There have been major advances in the availability of new antiretroviral medications and also TB prevention options for children, but these advances have come with additional questions surrounding drug–drug interactions and dosing in younger age groups. Finally, we review new approaches to manage post-TB lung disease in children living with HIV. Collectively, we present data on the rapidly evolving field of HIV-associated child tuberculosis. This evolution offers new management opportunities for children and adolescents living with HIV while also generating new questions for additional research.

THE TREATMENT OF PRIMARY TUBERCULOSIS IN CHILDHOOD

PEDIATRICS ◽  
1960 ◽  
Vol 26 (4) ◽  
pp. 641-653
Author(s):  
A. Lotte ◽  
H. Noufflard ◽  
Robert Debrá ◽  
H. E. Brissaud
Keyword(s):  
Children And Adolescents ◽  
Acquired Resistance ◽  
Age Groups ◽  
Primary Tuberculosis ◽  
Definite Answer ◽  
Spontaneous Course ◽  
Resistant Strains ◽  
Statistical Survey ◽  
Tuberculosis In Children

A preliminary inquiry of the Institut National d'Hygiéne (France), based on the follow-up of 5,526 cases of primary tuberculosis in children and adolescents, is reported; 1,425 cases were seen before 1955 and included in the statistical survey concluded in June, 1956. The spontaneous course of 895 patients who received no treatment is analyzed; special emphasis is placed on complications and their relative incidence in the different age groups and forms of primary tuberculosis. Comparative studies of treated and untreated cases were possible only in patients under 15 years of age and in clinically manifest forms of tuberculosis (Types II, III, and IV). These cases represent a total of 1,061 cases; 564 patients received treatment, 497 received no treatment. Findings in the different age groups are analyzed. A bacteriologic inquiry was also made on the problem of contamination with streptomycin- and isoniazid-resistant strains of M. tuberculosis and on secondarily acquired resistance to isoniazid in treated patients. A decrease of more than 80% in the incidence of complications led to the conclusion that routine chemotherapy should be resorted to in clinically manifest primary tuberculosis in children and adolescents. In the case of completely latent primary tuberculosis, however, a definite answer cannot be given as yet. It is the purpose of the future development of the trial to try to answer that question.

Polypharmacy and Drug–Drug Interactions in People Living With Human Immunodeficiency Virus in the Region of Madrid, Spain: A Population-Based Study

2019 ◽  
Vol 71 (2) ◽  
pp. 353-362 ◽  
Author(s):  
Beatriz López-Centeno ◽  
Carlos Badenes-Olmedo ◽  
Ángel Mataix-Sanjuan ◽  
Katie McAllister ◽  
José M Bellón ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Drug Interactions ◽  
Age Groups ◽  
Population Based ◽  
People Living With Hiv ◽  
Traffic Light ◽  
Population Based Study ◽  
Immunodeficiency Virus ◽  
Red Flag ◽  
Living With Hiv

Abstract Background Drug–drug interactions (DDIs) that involve antiretrovirals (ARVs) tend to cause harm if unrecognized, especially in the context of comorbidity and polypharmacy. Methods A linkage was established between the drug dispensing registry of Madrid and the Liverpool human immunodeficiency virus (HIV) DDI database (January 2017–June 2017). Polypharmacy was defined as the use of ≥5 non-HIV medications, and DDIs were classified by a traffic-light ranking for severity. Results A total of 22 945 people living with HIV (PLWH) and 6 613 506 individuals without HIV had received medications. ARV regimens were predominantly based on integrase inhibitors (51.96%). Polypharmacy was higher in PLWH (32.94%) than individuals without HIV (22.16%; P < .001); this difference was consistently observed across all age strata except for individuals ≥75 years. Polypharmacy was more common in women than men in both PLWH and individuals without HIV. The prevalence of contraindicated combinations involving ARVs was 3.18%. Comedications containing corticosteroids, quetiapine, or antithrombotic agents were associated with the highest risk for red-flag DDI, and the use of raltegravir- or dolutegravir-based antiretroviral therapy was associated with an adjusted odds ratio of 0.72 (95% confidence interval, .60–.88; P = .001) for red-flag DDI. Conclusions Polypharmacy was more frequent among PLWH across all age groups except those aged ≥75 years and was more common in women. The detection of contraindicated medications in PLWH suggests a likely disconnect between hospital and community prescriptions. Switching to alternative unboosted integrase regimens should be considered for patients with risk of harm from DDIs.

Cardiovascular Fitness and Body Composition of Youth with and without Mental Retardation

2001 ◽  
Vol 18 (2) ◽  
pp. 127-141 ◽  
Author(s):  
Kenneth H. Pitetti ◽  
Daniel A. Yarmer ◽  
Bo Fernhall
Keyword(s):  
Mental Retardation ◽  
Sample Size ◽  
Children And Adolescents ◽  
Aerobic Fitness ◽  
Test Performance ◽  
Age Groups ◽  
Cardiovascular Fitness ◽  
Late Adolescents ◽  
Gender And Age ◽  
Run Test

The purpose of this study was to compare the aerobic fitness and body mass index (BMI) of children and adolescents (8-18 yr) with and without mild mental retardation (MR). Sample size of participants with MR but without Down syndrome was 169 males and 99 females. Sample size of participants without MR was 289 males and 317 females. Analysis was made by gender and age: children (8-10 yr); early adolescents (11-14 yr); and late adolescents (15-18 yr). The 20-m shuttle run test (20 MST) was used to assess field test performance and predicted aerobic fitness. For all age groups, females and males without MR ran significantly more laps and had a significantly higher predicted aerobic fitness (V̇O2peak: ml $$ kg-1 $$ min-1) than their peers with MR. Additionally, participants with MR tended to have higher BMI than their peers without MR. The results of this study indicate that children and adolescents with MR have lower exercise capacity, lower aerobic fitness, and higher BMIs than their peers without MR.

Analysis of the main epidemiological parameters of morbidity with tuberculosis of children and adolescents of the Ryazan region in 2010–2019

2021 ◽  
Vol 29 (3) ◽  
pp. 355-362
Author(s):  
Elena L. Senkina ◽  
Inna V. Seregina
Keyword(s):  
Children And Adolescents ◽  
Active Form ◽  
Age Groups ◽  
Mathematical Methods ◽  
Clinical Form ◽  
The Status ◽  
General Improvement ◽  
Tuberculosis In Children ◽  
The Given ◽  
Epidemiological Parameters

AIM: This study aimed to identify the main trends of the epidemiology of tuberculosis in children and adolescents in the Ryazan Region (RR) by analyzing the main epidemiological parameters of morbidity in 20102019. MATERIALS AND METHODS: The morbidity of children and adolescents with tuberculosis in the RR was subjected to retrospective epidemiological analysis. The data of the official and reporting documentation of the Ryazan Regional Clinical Antituberculosis Dispensary and the materials of the state reports of Territorial Administration of Rospotrebnadzor (On the Condition of SanitaryEpidemiological WellBeing of Population) in 20102019 were used. The main epidemiological parameters of morbidity due to tuberculosis were calculated using mathematical methods. RESULTS: The proportion of children and adolescents in the structure of morbidity due to tuberculosis in the RR in 20102019 decreased by 3.9 times and reached 6.09% in 2019. The morbidity caused by the active form of tuberculosis in children (014 years) and adolescents (1517 years) evidently declined by -20.7% and -11.5%, respectively. In children, respiratory tuberculosis predominated (55%100%), and the leading clinical form was tuberculosis in intrathoracic lymph nodes (77%). In adolescents, only pulmonary tuberculosis was identified, and focal tuberculosis was the predominating clinical form (43%). In the study period, the highest morbidity in children was recorded at the age of 714 years. No cases of mortality among children and adolescents with tuberculosis were recorded in 20102019. In 20182019, the primary infection and the risk of infection among children under 14 years of age increased from 1.3% (2018) to 1.8% (2019) and from 2.6% (2018) to 3.3% (2019), respectively. This result might indicate that morbidity due to tuberculosis increased. The majority of ill children and adolescents were identified among vaccinated ones, suggesting that the protective properties of the vaccine were insufficient (80%). CONCLUSION: The morbidity of children and adolescents with tuberculosis decreased, and this decrease directly associated with the general improvement in the status of tuberculosis in the country; in particular, tuberculosis foci in the RF decreased by 2.2 times [4]. In the study period, the morbidity of children (014 years) decreased by 3.5 and 2.1 times in the RR and RF, respectively. The morbidity of adolescents (1517 years) decreased by 3.1 and 2.2 times in the RR and RF, respectively. The mortality of children and adolescents in the RP was 0.0 per 100,000 population of the given age groups. In the RF, their mortalities reduced by 6.5 and 1.6 times, respectively [4].

Treatment of Multidrug-Resistant Tuberculosis in Children and Adolescents

2017 ◽  
Vol 13 (02) ◽  
pp. 153-168
Author(s):  
Jennifer Furin ◽  
Silvia Chiang
Keyword(s):  
Children And Adolescents ◽  
Management Strategies ◽  
Evidence Base ◽  
Multidrug Resistant ◽  
Current Management ◽  
Future Directions ◽  
Resistant Tuberculosis ◽  
Multidrug Resistant Tuberculosis ◽  
Mdr Tb ◽  
Tuberculosis In Children

AbstractAlthough tens of thousands of children and adolescents become sick with multidrug-resistant tuberculosis (MDR-TB) each year, fewer than 1,500 cases documenting treatment have been reported in the literature. Children treated for MDR-TB tend to have excellent clinical outcomes, but they suffer from the adverse events associated with current management strategies. This article will review the recommendations, evidence base, and future directions for MDR-TB therapy in children and adolescents.

scholarly journals TUBERCULOSIS IN CHILDREN AND ADOLESCENTS OF VARIOUS AGE GROUPS IN SARATOV REGION

2016 ◽  
Vol 94 (6) ◽  
pp. 25-30 ◽  
Author(s):  
E.N. Aleksandrova ◽  
◽  
T.I. Morozova ◽  
N.P. Doktorova ◽  
◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Age Groups ◽  
Saratov Region ◽  
Tuberculosis In Children

scholarly journals WS9.2 Modified shuttle test performance in CF children and adolescents with different severity of lung disease

2014 ◽  
Vol 13 ◽  
pp. S19
Author(s):  
C. Cazzarolli ◽  
A. Zanini ◽  
C. Tartali ◽  
E. Salonini ◽  
S. Tomezzoli ◽  
...  
Keyword(s):  
Lung Disease ◽  
Children And Adolescents ◽  
Test Performance

IPM—A Problem-based Learning Approach

HortScience ◽  
1998 ◽  
Vol 33 (3) ◽  
pp. 509e-509
Author(s):  
Robert P. Rice
Keyword(s):  
Pest Control ◽  
Test Performance ◽  
Management Strategies ◽  
Ornamental Plants ◽  
Real Life ◽  
Problem Based Learning ◽  
Control Measures ◽  
Learning Approach ◽  
Pest Monitoring ◽  
Use Of Resources

The Cal Poly philosophy of “Learn and Understand by Doing” has been integrated with problem-based learning and the use of the latest technology to produce a class that closely simulates real-life pest control situations. Goals of the class, Disease and Pest Control Systems for Ornamental Plants, are to teach students pest monitoring, control and problem solving techniques, the use of resources including the internet and journals, and the use of the latest pest control equipment and application techniques. Students are shown pest situations and then work in groups to diagnose the problem, investigate management strategies, apply control measures, and monitor results. Weekly class presentations inform the class of the various projects and help to teach the class organization and presentation skills. Student evaluations and test performance have demonstrated that students achieve class objectives substantially better with the problem-based learning approach than with the previous lecture-based approach to the class.

scholarly journals Religion: Interrelationships and Opinions in Children and Adolescents. Interaction between Age and Beliefs

Religions ◽  
2021 ◽  
Vol 12 (5) ◽  
pp. 357
Author(s):  
Rafael López Cordero ◽  
Francisca Ruiz Garzón ◽  
Lourdes Medina Martínez ◽  
María del Carmen Olmos-Gómez
Keyword(s):  
Children And Adolescents ◽  
Current Trend ◽  
Age Groups ◽  
Cross Sectional Study ◽  
Experimental Methodology ◽  
Cross Sectional ◽  
Younger Age ◽  
Religious Issue ◽  
Quasi Experimental ◽  
Quantitative Descriptive

The current trend of secularization seems to be leading to a gradual withdrawal of religion from public spaces. However, in an increasingly internationalized world, it is becoming more and more important to study the roles of religion and religiosity and their potential in relation to dialogue and social conflicts and tensions. Education is a vital field within which to address this religious issue and create an educational dialogue in order to promote coexistence. By following a quantitative, descriptive, cross-sectional study, based on a quasi-experimental methodology with a social–analytical character, our aim is to assess the existing connections between religion, interrelation and opinion in Spanish children and adolescents. Special attention is paid to the interaction between age and beliefs. We carried out our study with the use of a questionnaire distributed to eleven secondary schools, with students aged between 11 and 16 years old, in three regions of southern Spain (Andalusia, Ceuta, and Melilla) characterized by high religious diversity and multiculturalism. The multivariate analysis carried out in this study identifies the effects of variance on the influence of age and religion, highlighting the interaction between the two. It is observed that the youngest students are those who express their opinions about religion the least, while those belonging to younger age groups and majority religions are those who express a greater religious coexistence, with Muslims externalizing their religious condition the most.

scholarly journals Understanding the Impact of Different Landscape-Level Fuel Management Strategies on Wildfire Hazard in Central Portugal

Forests ◽  
2021 ◽  
Vol 12 (5) ◽  
pp. 522
Author(s):  
Akli Benali ◽  
Ana C. L. Sá ◽  
João Pinho ◽  
Paulo M. Fernandes ◽  
José M. C. Pereira
Keyword(s):  
Management Strategies ◽  
Treatment Strategies ◽  
Fire Season ◽  
Burned Area ◽  
Treatment Area ◽  
Fuel Treatment ◽  
The North ◽  
Wildfire Hazard ◽  
Central Portugal ◽  
The Impact

The extreme 2017 fire season in Portugal led to widespread recognition of the need for a paradigm shift in forest and wildfire management. We focused our study on Alvares, a parish in central Portugal located in a fire-prone area, which had 60% of its area burned in 2017. We evaluated how different fuel treatment strategies may reduce wildfire hazard in Alvares through (i) a fuel break network with different extents corresponding to different levels of priority and (ii) random fuel treatments resulting from a potential increase in stand-level management intensity. To assess this, we developed a stochastic wildfire simulation system (FUNC-SIM) that integrates uncertainties in fuel distribution over the landscape. If the landscape remains unchanged, Alvares will have large burn probabilities in the north, northeast and center-east areas of the parish that are very often associated with high fireline intensities. The different fuel treatment scenarios decreased burned area between 12.1–31.2%, resulting from 1–4.6% increases in the annual treatment area and reduced the likelihood of wildfires larger than 5000 ha by 10–40%. On average, simulated burned area decreased 0.22% per each ha treated, and cost-effectiveness decreased with increasing area treated. Overall, both fuel treatment strategies effectively reduced wildfire hazard and should be part of a larger, holistic and integrated plan to reduce the vulnerability of the Alvares parish to wildfires.

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