PREVALENCE AND ASSOCIATED FACTORS FOR HIV AND TUBERCULOSIS
CO INFECTION, DESSIE REFERRAL HOSPITAL & HEALTH CENTER, Getachew G/mariam, MSc, college of Dessie health sciences, Dessie, Fikre Enqusilasie , PhD, school of public heath, Addis Ababa University, Addis Ababa, Ethiopia. Abstract
Background: tuberculosis is the most serious opportunistic infection for people infected with HIV in developing countries. A majority of co infected cases are in sub Saharan Africa, where up to 80 percent of TB patients may be co-infected with HIV. In Ethiopia, a routine national data showed the co-infection rate of 31%. HIV prevalence studies among TB patients at segmented areas of the country showed as high as 52.1% in University of Gondar hospital and as low as 18% in SNNPR. Having information about the status of co infection rate can help to improve the TB/HIV collaboration program. Thus, this study was intended to determine the rate of HIV infection and associated factors in TB patients at Dessie referral hospital and Dessie health center, Amahara national regional state.
Methods: A cross sectional analytic study was conducted from August to September 2010. As the sample size calculated from Epi info statcalc was 513, all 516 TB patients recorded from July 2009 to June 2010 (2002 EFY) were assessed for their socio demographic characteristics, TB classification, and HIV status. Data was entered and analyzed using Epi info 2002 and SPSS version 15 software.
Results: of the 516 TB patients assessed, 55% [(95%CI: 50.6% - 59.4%)] were HIV positive. The rate of HIV infection was significantly higher in TB patients with the age group of 40-49 (73.9%) and 30-39 (71.5%) years [OR = 6.61(95% CI: 1.97-23.07; p value = 0.001)] and [OR = 5.86(95% CI: 1.94-18.45; p value = 0.001) respectively. However, the rate of HIV infection between urban (56.1%) and rural (49.4%) residents, women (58.1%) and men (52.8%), hospital (57.7%) and health center (52.7%) in TB patients did not show statistical difference. In addition, the difference in the prevalence of HIV among TB smear negative (56.9%), extra pulmonary TB (56.9%), and TB smear positive (52.8%) cases was not statistically significant. Even though the concentration of TB patients was the highest in the age group of 20-29 (33.7%) followed by 30 – 39 (29.3%), the prevalence rate of HIV infection in TB patients was the highest in the age group of 40-49 years.
Conclusion: the prevalence of HIV among TB patients in the study areas was higher than the national average and several study results at segmented areas in the country. Though the concentration of TB cases was the highest among the age group of 20-29 years, the age group with the highest risk of contracting TB/HIV co infection was 40-49 years.
Recommendations: program managers should strengthen TB-HIV collaborative activities: offering provider initiated HIV counseling and testing for all TB patients giving special emphasis for 30-49 years of age, provision of Co-trimoxazole Prophylaxis Therapy (CPR) for HIV confirmed TB patients, linkage with ART clinic, and screening HIV positive patients for tuberculosis disease. A wide representative study on consecutively enrolled TB patients should be initiated.
Tuberculosis is the most common serious opportunistic infection in HIV positive patients and is the manifestation of AIDS in more than 50% of cases in developing countries (4). Worldwide, two billion people are infected with tuberculosis. Yearly, 8-10 million people contract TB and 2 million die from it. The HIV epidemic has worsened the TB situation. It is estimated that 60% or more of HIV infected people will develop TB disease in their life time in contrast with HIV negative persons whose life time risk is only 10%. As many as one third of 40 million people living with HIV infection worldwide is co-infected with TB (1, 3).
The co infection rate is high in sub Saharan Africa, where...