Tuberculosis in adolescents and young adults: epidemiology and treatment outcomes in the Western Cape

K Snow; A C Hesseling; P Naidoo; S M Graham; J Denholm; K du Preez

doi:10.5588/ijtld.16.0866

Tuberculosis in adolescents and young adults: epidemiology and treatment outcomes in the Western Cape

Int J Tuberc Lung Dis. 2017 Jun 1;21(6):651-657. doi: 10.5588/ijtld.16.0866.

Authors

K Snow¹, A C Hesseling², P Naidoo², S M Graham³, J Denholm⁴, K du Preez²

Affiliations

¹ Centre for International Child Health, University of Melbourne, Department of Paediatrics and Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Victoria, School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia.
² Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
³ Centre for International Child Health, University of Melbourne, Department of Paediatrics and Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Victoria, International Union Against Tuberculosis and Lung Disease, Paris, France.
⁴ Victorian Tuberculosis Program, Melbourne Health, Melbourne, Victoria, Department of Microbiology and Immunology, University of Melbourne, Melbourne, Victoria, Australia.

PMID: 28482959
DOI: 10.5588/ijtld.16.0866

Abstract

Setting: Western Cape Province, South Africa.

Objectives: To characterise tuberculosis (TB) epidemiology, disease presentation and treatment outcomes among adolescents (age 10-19 years) and young adults (age 20-24 years) in the Western Cape.

Design: A retrospective, cross-sectional review of routine patient-level data from the Electronic TB Register (ETR.Net) for 2013. Site of TB disease, human immunodeficiency virus (HIV) status and TB treatment outcomes were analysed by 5-year age groups (<5, 5-9, 10-14, 15-19, 20-24 and 25 years of age). TB notification rates were calculated using census data.

Results: Adolescents and young adults comprised 18.0% of all new TB notifications in 2013. The notification rate was 141 TB cases/100 000 person-years (py) among 10-14 year olds, 418/100 000 py among 15-19 year olds and 627/100 000 py among 20-24 year olds. HIV prevalence among TB patients was 10.9% in 10-14 year olds, 8.8% in 15-19 year olds and 27.2% in 20-24 year olds. Older adolescents (age 15-19 years) and young adults (age 20-24 years) with HIV co-infection had poor treatment outcomes: 15.6% discontinued treatment prematurely and 4.0% died.

Conclusions: Young people in the Western Cape suffer a substantial burden of TB, and those with TB-HIV co-infection are at high risk of treatment discontinuation.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Adult
Age Distribution
Antitubercular Agents / therapeutic use*
Child
Child, Preschool
Coinfection
Cost of Illness
Cross-Sectional Studies
Disease Notification / statistics & numerical data*
Female
HIV Infections / epidemiology*
HIV Infections / prevention & control
Humans
Male
Prevalence
Retrospective Studies
South Africa / epidemiology
Treatment Outcome
Tuberculosis / drug therapy
Tuberculosis / epidemiology*
Tuberculosis / prevention & control
Young Adult

Substances

Antitubercular Agents