Prevalence of culture positive Tuberculosis and utility of a clinical diagnostic tool for the diagnosis of Tuberculosis among HIV Infected Children attending HIV/AIDS Care and Treatment in Dodoma Municipality, Central Tanzania.

OBJECTIVE: To evaluate the performance of the modified Keith Edwards TB clinical diagnostic tool among HIV infected children. METHODS: Cross sectional study of 252 HIV infected children < 15 years old suspected with TB at four HIV/AIDS Care Clinics in Dodoma, Tanzania from November 2018 - March 2019. The modified Keith Edwards TB clinical diagnostic tool was compared to gastric aspirates, lymphnode aspirates or sputum gene x-pert MTB/RIF and TB culture. Sensitivity, specificity, negative and positive predictive value of the clinical tool were determined. Data was analyzed using SPSS version 25. RESULTS: Out of 252 children evaluated, 13.5% (34/252) had TB using the clinical diagnostic tool and 5.2% (13/252) had culture positive TB. The sensitivity of the clinical tool was 76.9%, specificity of 90%. Culture positive TB predictors were lymphadenopathy (AOR 13.74, 95%CI (3.86 - 48.86) p value < 0.001), weight loss (AOR 3.19,95%CI (1.38 - 7.36) p value 0.007), and difficulty breathing (AOR 7.25, 95%CI (1.54 - 34.16) p value 0.012). CONCLUSION: The utility of the modified Keith Edwards clinical diagnostic tool for Tuberculosis diagnosis among HIV infected children is limited, calling for further validation. HIV infected children with lymphadenopathy, failure to thrive and difficulty in breathing are at high risk of Tuberculosis.

Successful treatment of XDR-TB patient in Tanzania: report of the first XDR-TB patient.

Drug-resistant tuberculosis (TB) is emerging as a new and serious public health challenge. We present the first case with confirmed extensive drug-resistant TB in Tanzania in a patient who had prior exposure to anti-TB drugs and a history of imprisonment in South Africa. The addition of bedaquiline to the treatment regime resulted in positive to negative sputum conversion. After a total of 30 months on treatment he was declared cured, remaining clinically stable and culture-negative throughout the follow-up. Close monitoring is important in managing drug-resistant TB cases, and good surveillance is required to detect drug-resistant TB to prevent further transmission.