ArticlePediatrics2021
Mortality in South African Children and Adolescents Routinely Treated for Tuberculosis.
Article in Pediatrics, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 2 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
22 citing papers in PubMed, 2 syntheses or guidelines pooled it, 26 citations in OpenAlex.
- Meta-analysis of TB & HIV co-infection mortality rate in sub-Saharan African children, youth, and adolescents.Italian journal of pediatrics · 2025Pooled it
- A systematic review of risk factors for mortality among tuberculosis patients in South Africa.Systematic reviews · 2023Pooled it
- Clinical Outcomes in Children With Human Immunodeficiency Virus Treated for Nonsevere Tuberculosis in the SHINE Trial.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2024Trial
- Article
- Paediatric tuberculosis treatment outcomes: a retrospective study at the Komfo Anokye teaching hospital in Ghana, 2014-2025.BMC pediatrics · 2026Article
- Linking Children and Adolescents With TB Disease to HIV Services in 16 PEPFAR-supported High TB/HIV-Burden Countries in Sub-Saharan Africa, October 2018-September 2022.The Pediatric infectious disease journal · 2026Article
- Population pharmacokinetics of pyrazinamide and ethambutol in children with tuberculosis with or without HIV.Antimicrobial agents and chemotherapy · 2026Article
- Tuberculosis Preventive Treatment for Pregnant People With HIV in South Africa: A Modeling Analysis of Clinical Benefits and Risks.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2025Article
- Tuberculosis Diagnosis, Treatment, and Prevention Services for Children Living with HIV in Low- and Middle-Income Countries: A Multiregional Site Survey.Journal of the Pediatric Infectious Diseases Society · 2025Article
- Patterns and Cofactors of Polyfunctional Mycobacteria-Specific T-Cell Response Restoration Following 6-Month Antiretroviral Treatment in Children With HIV.The Journal of infectious diseases · 2025Article
- Tuberculosis-related deaths at a tertiary hospital in Zambia: Insights into the prevalence and associated factors.PLOS global public health · 2024Article
- Effect of HIV infection on plasma exposure to first-line TB drugs and target attainment in children.The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease · 2023Article
- Optimal Timing of Antiretroviral Therapy Initiation in Children and Adolescents With Human Immunodeficiency Virus-Associated Pulmonary Tuberculosis.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2023Article
- Drug-Resistant Tuberculosis Treatment Outcomes among Children and Adolescents in Karachi, Pakistan.Tropical medicine and infectious disease · 2022Article
- Social Determinants of Adherence to Treatment for Tuberculosis Infection and Disease Among Children, Adolescents, and Young Adults: A Narrative Review.Journal of the Pediatric Infectious Diseases Society · 2022Review
- Profile and treatment outcomes among young patients with tuberculosis aged 15-24 years in Faridabad district of Haryana, India.BMJ open · 2022Article
- Priority Activities in Child and Adolescent Tuberculosis to Close the Policy-Practice Gap in Low- and Middle-Income Countries.Pathogens (Basel, Switzerland) · 2022Article
- National approaches to TB care in adolescents.The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease · 2022Review
- HIV-Associated Tuberculosis in Children and Adolescents: Evolving Epidemiology, Screening, Prevention and Management Strategies.Pathogens (Basel, Switzerland) · 2021Review
- The Impact of Tuberculosis on the Well-Being of Adolescents and Young Adults.Pathogens (Basel, Switzerland) · 2021Review
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Authors and funding
9 authors at 4 institutions in 3 countries.
Funding
Abstract
backgroundIn South Africa, tuberculosis (TB) is a leading cause of death among those <20 years of age. We describe changes in TB mortality among children and adolescents in South Africa over a 13-year period, identify risk factors for mortality, and estimate excess TB-related mortality.
methodsRetrospective analysis of all patients <20 years of age routinely recorded in the national electronic drug-susceptible TB treatment register (2004-2016). We developed a multivariable Cox regression model for predictors of mortality and used estimates of mortality among the general population to calculate standardized mortality ratios (SMRs).
resultsBetween 2004 and 2016, 729 463 children and adolescents were recorded on TB treatment; 84.0% had treatment outcomes and 2.5% (18 539) died during TB treatment. The case fatality ratio decreased from 3.3% in 2007 to 1.9% in 2016. In the multivariable Cox regression model, ages 0 to 4, 10 to 14, and 15 to 19 years (compared with ages 5 to 9 years) were associated with increased risk of mortality, as was HIV infection, previous TB treatment, and extrapulmonary involvement. The SMR of 15 to 19-year-old female patients was more than double that of male patients the same age (55.3 vs 26.2). Among 10 to 14-year-olds and those who were HIV-positive, SMRs increased over time.
conclusionsMortality in South African children and adolescents treated for TB is declining but remains considerable, with 2% dying during 2016. Adolescents (10 to 19 years) and those people living with HIV have the highest risk of mortality and the greatest SMRs. Interventions to reduce mortality during TB treatment, specifically targeting those at highest risk, are urgently needed.
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