Background
Methods
Study characteristics
Sample collection, transportation and processing
Bacterial culture, identification and antimicrobial susceptibility testing (AST)
Statistical analysis
Results
Participant clinical and socio-demographic characteristics
Variable | CLD+ | CLD- | P | |
---|---|---|---|---|
Site | Zimbabwe | 72% (241/336) | 74% (55/74) | 0.770 |
Sex | Female | 49% (166/336) | 62% (46/74) | 0.054 |
Age | Median (IQR) | 15 (13–18) | 16 (12–18) | 0.939 |
Anthropometric | ||||
BMI-for-age z -score2 | Median (IQR) | −1.114 (− 1.85, −0.28) | − 0.32 (− 0.83, − 0.58) | < 0.001 |
Height-for-age z-score a | <− 2 (Stunted) | 50% (168/336) | 30% (22/74) | 0.002 |
Weight-for-age z-score a | <−2 (Underweight) | 52% (176/336) | 19% (14/74) | < 0.001 |
Current drug use | ||||
Cotrimoxazole (CTX) | 91% (304/334) | 86% (60/70) | 0.188 | |
Antiretroviral regimen | λNNRTI-based regimen -1st line | 74% (247/335) | 89% (65/73) | 0.006 |
§PI-based regimen-2nd line | 26% (88/335) | 11% (8/73) | ||
HIV clinical parameters | ||||
CD4 count categories | > 500 cells/mm | 62% (208/336) | 67% (49/73) | 0.770 |
200–500 cells/mm | 28% (94/336) | 25% (18/73) | ||
< 200 cells/mm | 10% (34/336) | 8% (6/73) | ||
Viral load (VL) suppression | VL < 1000 copies/mL | 56% (187/336) | 66% (49/74) | 0.119 |
Age at ART initiation | Median (IQR) | 8 (6–12) | 9 (5–11) | 0.667 |
Years spent on ART | Median (IQR) | 6 (4–9) | 7 (4–9) | 0.571 |
Respiratory status | ||||
Previously treated for TB, % (N) | 29% (97/335) | 12% (9/73) | 0.003 | |
FEV1 z-score | Median (IQR) | −1.96 (−2.46, −1.47) | 0.52 (0.23, 0.79) | < 0.001 |
Admitted for chest problems in last 12 months | 2% (6/336) | 1% (1/74) | 1 | |
Asthma | 3% (11/336) | 0% (0/74) | 0.227 | |
MRC dyspnoea Score | 1 | 55% (185/336) | 78% (59/73) | 0.001 |
2 | 35% (120/336) | 16% (12/73) | ||
3 | 6% (19/336) | 3% (2/73) | ||
4 | 3% (10/336) | 0% (0/73) | ||
5 | 1% (2/336) | 0% (0/73) |
Prevalence of bacterial carriage
Bacterial species | Nasopharyngeal swabs | Sputum samples | ||||
---|---|---|---|---|---|---|
CLD+ (n = 336) | CLD- (n = 74) | p | CLD+ (n = 326) | CLD- (n = 74) | p | |
No. of isolates (%) | No. of isolates (%) | |||||
S. pneumoniae | 154 (46%) | 19 (26%) | 0.008 | 83 (25%) | 17 (23%) | 1 |
S. aureus | 77 (23%) | 9 (12%) | 0.164 | 93 (29%) | 21 (28%) | 1 |
H. influenzae | 40 (12%) | 4 (5%) | 0.576 | 12 (4%) | 2 (3%) | 1 |
M. catarrhalis | 49 (15%) | 2 (3%) | 0.012 | 30 (9%) | 4 (5%) | 1 |
≥ 1 bacterial species | 226 (67%) | 29 (39%) | < 0.001 | 161 (49%) | 37 (50%) | 1 |
Risk factors associated with carriage of bacteria
Variable | No. observations (n = 410) § | Streptococcus pneumoniae | Staphylococcus aureus | ||||||||
---|---|---|---|---|---|---|---|---|---|---|---|
No. isolates (n = 173)φ | OR [95% CI] | p | Adjusted OR [95% CI] | p | No. isolates (n = 86)λ | OR [95% CI] | p | Adjusted OR [95% CI] | p | ||
Group | |||||||||||
CLD- | 18% (74) | 11% (19) | Reference | Reference | 10% (9) | Reference | Reference | ||||
CLD+ | 82% (336) | 89% (154) | 2.5 [1.4–4.4] | 0.002 | 2.0[1.1–3.9] | 0.04 | 90% (77) | 2.2 [1.1–4.8] | 0.04 | 1.8 [0.8–4.5] | 0.17 |
Study site | |||||||||||
Malawi | 28% (114) | 32% (56) | Reference | Reference | 31% (27) | Reference | Reference | ||||
Zimbabwe | 72% (296) | 68% (117) | 0.7 [0.4–1.1] | 0.08 | 1.3 [0.7–2.4] | 0.42 | 69% (59) | 0.8 [0.5–1.4] | 0.40 | 0.7 [0.4–1.5] | 0.39 |
Sex | |||||||||||
Female | 52% (212) | 54% (94) | Reference | Reference | 41% (35) | Reference | Reference | ||||
Male | 48% (198) | 46% (79) | 0.8 [0.6–1.2] | 0.36 | 0.7 [0.4–1.0] | 0.07 | 59% (51) | 1.8 [1.1–2.9] | 0.02 | 1.7 [1.0–2.9] | 0.05 |
Season of sample collection | |||||||||||
Dec - Apr - Rainy season | 36% (149) | 32% (56) | Reference | Reference | 36% (31) | Reference | Reference | ||||
May–Aug - Cool season | 39% (160) | 43% (74) | 1.4 [0.9–2.3] | 0.30 | 1.7 [1.0–2.9] | 0.13 | 29% (25) | 0.7 [0.4–1.3] | 0.03 | 0.9 [0.5–1.6] | 0.11 |
Sep - Nov - Hot season | 25% (101) | 25% (43) | 1.2 [0.7–2.1] | 1.3 [0.7–2.3] | 35% (30) | 1.6 [0.9–2.9] | 1.7 [0.9–3.2] | ||||
Enrolment age category | |||||||||||
17-19y | 32% (131) | 20% (35) | Reference | Reference | 28% (24) | Reference | Reference | ||||
13-16y | 41% (168) | 47% (81) | 2.6 [1.6–4.2] | <0.001 | 2.2 [1.3–3.8] | <0.001 | 43% (37) | 1.3 [0.7–2.3] | 0.66 | 1.1 [0.6–2.1] | 0.83 |
6-12y | 27% (111) | 33% (57) | 2.9 [1.7–5.0] | 3.2 [1.8–5.8] | 29% (25) | 1.3 [0.7–2.4] | 1.2 [0.6–2.5] | ||||
Number of years on ART | |||||||||||
6 m- < 2y | 9% (35) | 14% (23) | Reference | Reference | 7% (6) | Reference | Reference | ||||
2- < 4y | 18% (72) | 18% (30) | 0.4 [0.2–0.9] | 0.02 | 0.4 [0.2–1.0] | 0.04 | 18% (15) | 1.3 [0.5–3.9] | 0.94 | 1.2 [0.4–3.9] | 0.78 |
4y- < 6y | 20% (81) | 22% (36) | 0.4 [0.2–0.9] | 0.4 [0.2–1.0] | 22% (18) | 1.4 [0.5–4.1] | 1.4 [0.5–4.4] | ||||
6y+ | 53% (214) | 47% (78) | 0.3 [0.1–0.6] | 0.3 [0.1–0.7] | 53% (44) | 1.3 [0.5–3.5] | 1.0 [0.4–3.0] | ||||
CD4 count | |||||||||||
> 500 | 63% (257) | 62% (108) | Reference | 63% (54) | Reference | ||||||
200–500 | 27% (112) | 24% (42) | 0.8 [0.5–1.3] | 0.09 | 30% (26) | 1.1 [0.7–1.9] | 0.55 | ||||
< 200 | 10% (40) | 13% (23) | 1.9 [1.0–3.7] | 7% (6) | 0.7 [0.2–1.6] | ||||||
Enrolment viral load | |||||||||||
Unsuppressed | 42% (174) | 46% (80) | Reference | Reference | 55% (47) | Reference | Reference | ||||
Suppressed | 58% (236) | 54% (93) | 0.8[0.5–1.1] | 0.18 | 0.6 [0.4–1.0] | 0.03 | 45% (39) | 0.5 [0.3–0.9] | 0.01 | 0.5 [0.3–0.9] | 0.02 |
ART regimen | |||||||||||
PI-based regimen - 2nd line | 24% (98) | 25% (44) | Reference | Reference | 33% (28) | Reference | Reference | ||||
NNRTI-based regimen -1st line | 76% (312) | 75% (129) | 0.9 [0.6–1.4] | 0.55 | 0.8 [0.5–1.4] | 0.44 | 67% (58) | 0.6 [0.3–1.0] | 0.03 | 0.6 [0.3–1.1] | 0.07 |
Ever treated for TB | |||||||||||
No | 74% (302) | 70% (120) | Reference | Reference | 71% (61) | Reference | Reference | ||||
Yes | 26% (106) | 30% (52) | 1.5 [0.9–2.3] | 0.10 | 1.5 [0.9–2.5] | 0.12 | 29% (25) | 1.2 [0.7–2.1] | 0.46 | 0.9 [0.5–1.7] | 0.83 |
Enrolment weight- for-age- z-score | |||||||||||
Not underweight | 54% (220) | 49% (85) | Reference | 49% (42) | Reference | ||||||
Underweight | 46% (190) | 51% (88) | 1.4 [0.9–2.0] | 0.12 | 51% (44) | 1.3 [0.8–2.1] | 0.31 | ||||
Enrolment height-for-age- z-score - | |||||||||||
Not stunted | 54% (220) | 45% (78) | Reference | Reference | 52% (45) | Reference | Reference | ||||
Stunted | 46% (190) | 55% (95) | 1.8 [1.2–2.7] | 0.003 | 1.6 [1.1–2.6] | 0.03 | 48% (41) | 1.1 [0.7–1.7] | 0.78 | 0.8 [0.5–1.3] | 0.39 |
Ever repeated a grade | |||||||||||
No | 46% (183) | 41% (69) | Reference | 42% (36) | Reference | ||||||
Yes | 54% (218) | 59% (100) | 1.4 [0.9–2.1] | 0.10 | 58% (49) | 1.2 [0.7–1.9] | 0.49 | ||||
MRC dyspnoea score | |||||||||||
1 or 0 | 60% (244) | 53% (91) | Reference | Reference | 56% (48) | Reference | Reference | ||||
> 1 | 40% (165) | 47% (81) | 1.6 [1.1–2.4] | 0.02 | 1.3 [0.7–2.2] | 0.36 | 44% (37) | 1.2 [0.7–1.9] | 0.50 | 1.0 [0.5–1.8] | 0.94 |
Variable | No. observations (n = 400) § | Streptococcus pneumoniae | Staphylococcus aureus | ||||||||
---|---|---|---|---|---|---|---|---|---|---|---|
No. isolates (n = 100)φ | OR [95% CI] | p | Adjusted OR [95% CI] | p | No. isolates (n = 114)λ | OR [95% CI] | p | Adjusted OR [95% CI] | p | ||
Group | |||||||||||
CLD- | 18% (74) | 17% (17) | Reference | Reference | 18% (21) | Reference | Reference | ||||
CLD+ | 82% (326) | 83% (83) | 1.2 [0.6–2.1] | 0.66 | 1.3 [0.6–2.6] | 0.52 | 82% (93) | 1.0 [0.6–1.8] | 0.98 | 1.0 [0.5–1.8] | 0.92 |
Study site | |||||||||||
Malawi | 27% (108) | 13% (13) | Reference | Reference | 18% (21) | Reference | Reference | ||||
Zimbabwe | 73% (292) | 87% (87) | 3.1 [1.7–6.1] | <0.001 | 3.1 [1.4–7.3] | 0.01 | 82% (93) | 1.9 [1.2–3.4] | 0.02 | 2.1 [1.1–4.2] | 0.04 |
Sex | |||||||||||
Female | 52% (207) | 52% (52) | Reference | Reference | 50% (57) | Reference | Reference | ||||
Male | 48% (193) | 48% (48) | 1 [0.6–1.6] | 0.95 | 0.9 [0.6–1.5] | 0.73 | 50% (57) | 1.1 [0.7–1.7] | 0.66 | 1.1 [0.7–1.8] | 0.57 |
Season of sample collection | |||||||||||
Dec–Apr - Rainy | 36% (143) | 26% (26) | Reference | Reference | 32% (37) | Reference | Reference | ||||
May–Aug - Cool | 39% (157) | 41% (41) | 1.6 [0.9–2.8] | 0.03 | 1.6 [0.9–3.0] | 0.04 | 37% (42) | 1.1 [0.6–1.8] | 0.25 | 1.1 [0.6–1.8] | 0.27 |
Sep–Nov - Hot | 25% (100) | 33% (33) | 2.2 [1.2–4.1] | 2.3 [1.2–4.4] | 31% (35) | 1.5 [0.9–2.7] | 1.6 [0.9–2.8] | ||||
Enrolment age category | |||||||||||
17-19y | 33% (130) | 38% (38) | Reference | Reference | 39% (45) | Reference | Reference | ||||
13-16y | 40% (161) | 39% (39) | 0.8 [0.5–1.3] | 0.34 | 0.8 [0.5–1.4] | 0.38 | 38% (43) | 0.7 [0.4–1.1] | 0.15 | 0.7 [0.4–1.2] | 0.25 |
6-12y | 27% (109) | 23% (23) | 0.7 [0.4–1.2] | 0.6 [0.3–1.2] | 23% (26) | 0.6 [0.3–1.0] | 0.6 [0.3–1.1] | ||||
Number of years on ART | |||||||||||
6 m- < 2y | 9% (35) | 12% (12) | Reference | Reference | 9% (10) | Reference | Reference | ||||
2- < 4y | 18% (71) | 21% (21) | 0.8 [0.3–1.9] | 0.39 | 0.6 [0.2–1.5] | 0.04 | 17% (19) | 0.9 [0.4–2.3] | 0.83 | 0.7 [0.3–1.8] | 0.57 |
4y- < 6y | 20% (79) | 19% (19) | 0.6 [0.3–1.5] | 0.4 [0.2–1.0] | 23% (26) | 1.2 [0.5–3.0] | 0.9 [0.4–2.4] | ||||
6y+ | 53% (208) | 47% (47) | 0.6 [0.3–1.2] | 0.3 [0.1–0.8] | 51% (58) | 1 [0.5–2.2] | 0.6 [0.3–1.6] | ||||
CD4 count | |||||||||||
> 500 | 63% (251) | 63% (63) | Reference | 59% (67) | Reference | ||||||
200–500 | 28% (110) | 26% (26) | 0.9 [0.5–1.6] | 0.81 | 32% (36) | 1.3 [0.8–2.2] | 0.51 | ||||
< 200 | 10% (38) | 11% (11) | 1.2 [0.6–2.5] | 10% (11) | 1.1 [0.5–2.3] | ||||||
Enrolment viral load | |||||||||||
Unsuppressed | 42% (169) | 35% (35) | Reference | 47% (54) | Reference | Reference | |||||
Suppressed | 58% (231) | 65% (65) | 1.5 [0.9–2.4] | 0.09 | 1.4 [0.8–2.3] | 0.22 | 53% (60) | 0.8 [0.5–1.2] | 0.19 | 0.7 [0.4–1.1] | 0.09 |
ART regimen | |||||||||||
PI-based regimen - 2nd line | 24% (98) | 27% (27) | Reference | Reference | 25% (28) | Reference | Reference | ||||
NNRTI-based regimen -1st line | 76% (302) | 73% (73) | 0.9 [0.5–1.5] | 0.57 | 1.1 [0.6–2.1] | 0.75 | 75% (86) | 1 [0.6–1.7] | 0.947 | 1.2 [0.7–2.2] | 0.54 |
Ever treated for TB | |||||||||||
No | 74% (294) | 65% (65) | Reference | Reference | 72% (82) | Reference | Reference | ||||
Yes | 26% (104) | 35% (35) | 1.8 [1.1–2.9] | 0.02 | 1.8 [1.0–3.2] | 0.04 | 28% (32) | 1.2 [0.7–1.9] | 0.58 | 1.0 [0.6–1.8] | 0.92 |
Enrolment weight- for-age- z-score | |||||||||||
Not underweight | 54% (217) | 61% (61) | Reference | 54% (61) | Reference | ||||||
Underweight | 46% (183) | 39% (39) | 0.7 [0.4–1.1] | 0.12 | 46% (53) | 1.0 [0.7–1.6] | 0.85 | ||||
Enrolment height-for-age- z-score - | |||||||||||
Not stunted | 55% (218) | 59% (59) | Reference | Reference | 58% (66) | Reference | Reference | ||||
Stunted | 46% (182) | 41% (41) | 0.8 [0.5–1.2] | 0.3 | 0.9 [0.5–1.5] | 0.64 | 42% (48) | 0.8 [0.5–1.3] | 0.39 | 0.8 [0.5–1.3] | 0.46 |
Ever repeated a grade | |||||||||||
No | 46% (180) | 49% (49) | Reference | 47% (54) | Reference | ||||||
Yes | 54% (211) | 51% (50) | 0.8 [0.5–1.3] | 0.43 | 53% (60) | 0.9 [0.6–1.4] | 0.74 | ||||
MRC dyspnoea score | |||||||||||
1 or 0 | 60% (240) | 68% (67) | Reference | Reference | 65% (73) | Reference | Reference | ||||
> 1 | 40% (159) | 32% (32) | 0.7 [0.4–1.0] | 0.079 | 0.9 [0.5–1.7] | 0.86 | 35% (40) | 0.8 [0.5–1.2] | 0.25 | 1.1 [0.6–2.0] | 0.67 |
Variable | No. observations (n = 410) § | Haemophilus influenzae | Moraxella catarrhalis | ||||||||
---|---|---|---|---|---|---|---|---|---|---|---|
No. isolates (n = 44)σ | OR [95% CI] | p | Adjusted OR [95% CI] | p | No. isolates (n = 51)ξ | OR [95% CI] | p | Adjusted OR [95% CI] | p | ||
Group | |||||||||||
CLD- | 18% (74) | 9% (4) | Reference | Reference | 4% (2) | Reference | Reference | ||||
CLD+ | 82% (336) | 91% (40) | 2.4 [0.9–8.1] | 0.11 | 1.5 [0.5–5.7] | 0.49 | 96% (49) | 6.2 [1.9–38.2] | 0.01 | 4.0 [1.1–26.2] | 0.08 |
Study site | |||||||||||
Malawi | 28% (114) | 23% (10) | Reference | Reference | 49% (25) | Reference | Reference | ||||
Zimbabwe | 72% (296) | 77% (34) | 1.4 [0.7–3.0] | 0.43 | 3.9 [1.5–11.7] | 0.01 | 51% (26) | 0.3 [0.2–0.6] | <0.001 | 0.6 [0.3–1.4] | 0.27 |
Sex | |||||||||||
Female | 52% (212) | 61% (27) | Reference | Reference | 51% (26) | Reference | Reference | ||||
Male | 48% (198) | 39% (17) | 0.6 [0.3–1.2] | 0.18 | 0.6 [0.3–1.2] | 0.13 | 49% (25) | 1.0 [0.6–1.9] | 0.91 | 1.0 [0.5–1.9] | 0.90 |
Season of sample collection | |||||||||||
Dec–April - Rainy season | 36% (149) | 30% (13) | Reference | Reference | 20% (10) | Reference | Reference | ||||
May–Aug - Cool season | 39% (160) | 50% (22) | 1.7 [0.8–3.5] | 0.29 | 1.9 [0.8–4.4] | 0.24 | 47% (24) | 2.5 [1.2–5.6] | 0.03 | 2.7 [1.2–6.7] | 0.04 |
Sep–Nov - Hot season | 25% (101) | 20% (9) | 1.0 [0.4–2.5] | 1.0 [0.4–2.7] | 33% (17) | 2.8 [1.3–6.7] | 3.1 [1.3–8.1] | ||||
Enrolment age category | |||||||||||
17-19y | 32% (131) | 16% (7) | Reference | Reference | 10% (5) | Reference | Reference | ||||
13-16y | 41% (168) | 61% (27) | 3.4 [1.5–8.7] | 0.01 | 3.6 [1.5–10.2] | 0.03 | 55% (28) | 5.0 [2.1–15.2] | 0.004 | 3.5 [1.3–11.1] | 0.04 |
6-12y | 27% (111) | 23% (10) | 1.8 [0.7–5.0] | 2.4 [0.8–7.7] | 35% (18) | 4.9 [1.9–15.2] | 4.0 [1.4–13.2] | ||||
Number of years on ART | |||||||||||
6 m- < 2y | 9% (35) | 15% (6) | Reference | Reference | 22% (11) | Reference | Reference | ||||
2- < 4y | 18% (72) | 22% (9) | 0.7 [0.2–2.2] | 0.40 | 0.6 [0.2–2] | 0.22 | 12% (6) | 0.2 [0.1–0.6] | 0.01 | 0.3 [0.1–0.8] | 0.09 |
4y- < 6y | 20% (81) | 20% (8) | 0.5 [0.2–1.7] | 0.4 [0.1–1.4] | 16% (8) | 0.2 [0.1–0.7] | 0.3 [0.1–0.9] | ||||
6y+ | 53% (214) | 44% (18) | 0.4 [0.2–1.3] | 0.3 [0.1–1.0] | 50% (25) | 0.3 [0.1–0.7] | 0.3 [0.1–0.9] | ||||
CD4 count | |||||||||||
> 500 | 63% (257) | 55% (24) | Reference | 55% (28) | Reference | ||||||
200–500 | 27% (112) | 20% (9) | 0.9 [0.4–1.8] | 0.003 | 31% (16) | 1.4 [0.7–2.6] | 0.4 | ||||
< 200 | 10% (40) | 25% (11) | 3.7 [1.6–8.2] | 14% (7) | 1.7 [0.7–4.1] | ||||||
Enrolment viral load | |||||||||||
Unsuppressed | 42% (174) | 50% (22) | Reference | Reference | 47% (24) | Reference | Reference | ||||
Suppressed | 58% (236) | 50% (22) | 0.7 [0.4–1.3] | 0.28 | 0.6 [0.3–1.2] | 0.13 | 53% (27) | 0.8 [0.5–1.5] | 0.48 | 0.6 [0.3–1.2] | 0.14 |
ART regimen | |||||||||||
PI-based regimen - 2nd line | 24% (98) | 27% (12) | Reference | Reference | 29% (15) | Reference | Reference | ||||
NNRTI-based regimen -1st line | 76% (312) | 73% (32) | 0.8 [0.4–1.9] | 0.74 | 0.9 [0.4–2.2] | 0.83 | 71% (36) | 0.8 [0.4–1.5] | 0.43 | 0.6 [0.3–1.5] | 0.27 |
Ever treated for TB | |||||||||||
No | 74% (302) | 61% (27) | Reference | Reference | 70% (35) | Reference | Reference | ||||
Yes | 26% (106) | 39% (17) | 2.0 [1.0–3.7] | 0.05 | 2.1 [1.0–4.6] | 0.06 | 30% (15) | 1.3 [0.6–2.4] | 0.49 | 1.2 [0.5–2.6] | 0.63 |
Enrolment weight- for-age- z-score | |||||||||||
Not underweight | 54% (220) | 55% (24) | Reference | 37% (19) | Reference | ||||||
Underweight | 46% (190) | 45% (20) | 1.0 [0.5–1.8] | 0.90 | 63% (32) | 2.1 [1.2–4] | 0.01 | ||||
Enrolment height-for-age- z-score - | |||||||||||
Not stunted | 54% (220) | 57% (25) | Reference | Reference | 37% (19) | Reference | Reference | ||||
Stunted | 46% (190) | 43% (19) | 0.9 [0.5–1.6] | 0.66 | 0.7 [0.3–1.5] | 0.40 | 63% (32) | 2.1 [1.2–4] | 0.01 | 1.5 [0.8–3.0] | 0.25 |
Ever repeated a grade | |||||||||||
No | 46% (183) | 36% (15) | Reference | 28% (14) | Reference | ||||||
Yes | 54% (218) | 64% (27) | 1.6 [0.8–3.2] | 0.18 | 72% (36) | 2.4 [1.3–4.7] | 0.01 | ||||
MRC dyspnoea score | |||||||||||
1 or 0 | 60% (244) | 50% (22) | Reference | Reference | 33% (17) | Reference | Reference | ||||
> 1 | 40% (165) | 50% (22) | 1.6 [0.8–2.9] | 0.17 | 2.6 [1.2–5.8] | 0.02 | 67% (34) | 3.5 [1.9–6.6] | <0.001 | 2.4 [1.1–5.4] | 0.04 |
Variable | No. observations (n = 400) § | Haemophilus influenzae | Moraxella catarrhalis | ||||||||
---|---|---|---|---|---|---|---|---|---|---|---|
No. isolates (n = 14)σ | OR [95% CI] | p | Adjusted OR [95% CI] | p | No. isolates (n = 34)ξ | OR [95% CI] | p | Adjusted OR [95% CI] | p | ||
Group | |||||||||||
CLD- | 18% (74) | 14% (2) | Reference | Reference | 12% (4) | Reference | Reference | ||||
CLD+ | 82% (326) | 86% (12) | 1.4 [0.4–9.0] | 0.68 | 0.8 [0.1–6.6] | 0.82 | 88% (30) | 1.8 [0.7–6.1] | 0.30 | 1.4 [0.5–5.0] | 0.6 |
Study site | |||||||||||
Malawi | 27% (108) | 43% (6) | Reference | Reference | 38% (13) | Reference | Reference | ||||
Zimbabwe | 73% (292) | 57% (8) | 0.5 [0.2–1.5] | 0.18 | 1.1 [0.2–7.7] | 0.88 | 62% (21) | 0.6 [0.3–1.2] | 0.13 | 0.6 [0.2–1.7] | 0.36 |
Sex | |||||||||||
Female | 52% (207) | 57% (8) | Reference | Reference | 59% (20) | Reference | Reference | ||||
Male | 48% (193) | 43% (6) | 0.8 [0.3–2.3] | 0.68 | 1.5 [0.4–5.8] | 0.53 | 41% (14) | 0.7 [0.4–1.5] | 0.39 | 0.6 [0.3–1.3] | 0.18 |
Season of sample collection | |||||||||||
Dec–Apr - Rainy | 36% (143) | 50% (7) | Reference | Reference | 32% (11) | Reference | Reference | ||||
May–Aug - Cool | 39% (157) | 43% (6) | 0.8 [0.2–2.4] | 0.32 | 0.9 [0.2–3.7] | 0.42 | 38% (13) | 1.1 [0.5–2.6] | 0.81 | 1.0 [0.4–2.6] | 0.65 |
Sep–Nov - Hot | 25% (100) | 7% (1) | 0.2 [0.01–1.1] | 0.2 [0.0–1.6] | 29% (10) | 1.3 [0.5–3.3] | 1.5 [0.6–3.9] | ||||
Enrolment age category | |||||||||||
17-19y | 33% (130) | 14% (2) | Reference | Reference | 24% (8) | Reference | Reference | ||||
13-16y | 40% (161) | 57% (8) | 3.3 [0.8–22.4] | 0.32 | 6.1 [0.9–119.9] | 0.24 | 56% (19) | 2.0 [0.9–5.1] | 0.16 | 1.6 [0.6–4.0] | 0.39 |
6-12y | 27% (109) | 29% (4) | 2.4 [0.5–17.8] | 6.7 [0.9–140.2] | 21% (7) | 1.0 [0.4–3.0] | 0.9 [0.3–2.6] | ||||
Number of years on ART | |||||||||||
6 m- < 2y | 9% (35) | 9% (1) | Reference | Reference | 15% (5) | Reference | Reference | ||||
2- < 4y | 18% (71) | 9% (1) | 0.5 [0.0–12.5] | 0.58 | 0.3 [0.0–8.6] | 0.68 | 24% (8) | 0.8 [0.2–2.7] | 0.38 | 0.8 [0.2–2.9] | 0.39 |
4y- < 6y | 20% (79) | 36% (4) | 1.8 [0.3–36.2] | 1.3 [0.1–27.4] | 18% (6) | 0.5 [0.1–1.8] | 0.5 [0.1–2.0] | ||||
6y+ | 53% (208) | 45% (5) | 0.8 [0.1–16.3] | 0.8 [0.1–16.4] | 42% (14) | 0.4 [0.2–1.4] | 0.4 [0.1–1.4] | ||||
CD4 count | |||||||||||
> 500 | 63% (251) | 43% (6) | Reference | 62% (21) | Reference | ||||||
200–500 | 28% (110) | 21% (3) | 1.1 [0.2–4.4] | 0.01 | 26% (9) | 1.0 [0.4–2.1] | 0.9 | ||||
< 200 | 10% (38) | 36% (5) | 6.2 [1.7–21.7] | 12% (4) | 1.3 [0.4–3.6] | ||||||
Enrolment viral load | |||||||||||
Unsuppressed | 42% (169) | 64% (9) | Reference | Reference | 47% (16) | Reference | Reference | ||||
Suppressed | 58% (231) | 36% (5) | 0.4 [0.1–1.2] | 0.1 | 0.4 [0.1–1.3] | 0.13 | 53% (18) | 0.8 [0.4–1.7] | 0.55 | 0.8 [0.4–1.8] | 0.64 |
ART regimen | |||||||||||
PI-based regimen - 2nd line | 24% (98) | 14% (2) | Reference | Reference | 29% (10) | Reference | Reference | ||||
NNRTI-based regimen -1st line | 76% (302) | 86% (12) | 3.9 [0.8–72.1] | 0.19 | 3.9 [0.6–77.4] | 0.23 | 71% (24) | 0.8 [0.4–2.0] | 0.66 | 0.7 [0.3–1.9] | 0.49 |
Ever treated for TB | |||||||||||
No | 74% (294) | 64% (9) | Reference | Reference | 76% (26) | Reference | Reference | ||||
Yes | 26% (104) | 36% (5) | 1.6 [0.5–4.7] | 0.41 | 3.2 [0.8–12.3] | 0.09 | 24% (8) | 0.9 [0.4–1.9] | 0.72 | 0.8 [0.3–2.0] | 0.68 |
Enrolment weight- for-age- z-score | |||||||||||
Not underweight | 54% (217) | 50% (7) | Reference | 32% (11) | Reference | ||||||
Underweight | 46% (183) | 50% (7) | 1.2 [0.4–3.6] | 0.75 | 68% (23) | 2.7 [1.3–5.9] | 0.01 | ||||
Enrolment height-for-age- z-score - | |||||||||||
Not stunted | 55% (218) | 57% (8) | Reference | Reference | 41% (14) | Reference | Reference | ||||
Stunted | 46% (182) | 43% (6) | 0.9 [0.3–2.6] | 0.84 | 1.4 [0.4–5.3] | 0.65 | 59% (20) | 1.8 [0.9–3.7] | 0.11 | 1.7 [0.8–3.9] | 0.17 |
Ever repeated a grade | |||||||||||
No | 46% (180) | 50% (7) | Reference | 39% (13) | Reference | ||||||
Yes | 54% (211) | 50% (7) | 0.9 [0.3–2.5] | 0.76 | 61% (20) | 1.4 [0.7–2.9] | 0.43 | ||||
MRC dyspnoea score | |||||||||||
1 or 0 | 60% (240) | 57% (8) | Reference | Reference | 56% (19) | Reference | Reference | ||||
> 1 | 40% (159) | 43% (6) | 1.1 [0.4–3.3] | 0.82 | 0.8 [0.1–4.4] | 0.80 | 44% (15) | 1.2 [0.6–2.5] | 0.60 | 0.9 [0.3–2.2] | 0.79 |