Tuberculosis in adolescents and young adults: epidemiology and treatment outcomes in the Western Cape
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.
Keywords: TB-HIV; adherence; loss to follow-up
Document Type: Research Article
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
Publication date: 01 June 2017
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