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Risk Factors Associated with the Development of Tuberculosis Among HIV-Infected Patients in Khartoum in 2010

1 Public Health Specialist, Federal Ministry of Health, Public Health Institute, Khartoum, Sudan;
2 Professor of Public Health, Ahfad University for Women, Omdurman, Sudan and WHO regional consultant;
3 Epdemiologist, Federal Ministry of Health, Directorate of Epidemiology and Zoonotic diseases, Khartoum, Sudan;
4 Community Physician, Federal Ministry of Health, National Medical Commission, Khartoum, Sudan

Special Issues: Health Promotion and Disease Prevention among Most Vulnerable Populations

Background: Tuberculosis (TB) screening among patients infected with Human Immunodeficiency Virus (HIV) is one of the approaches for controlling TB-HIV co-infection. The absence of typical TB symptoms among HIV-infected patients makes diagnosis challenging. Identifying predisposing risk factors of TB among HIV-infected patients could possibly guide TB diagnosis and treatment. This study was designed to identify some important factors associated with TB among HIV-infected patients and to quantify the strength of this association.
Methodology: In 2010, a case control study was conducted in Khartoum State, Sudan. Cases and controls were selected by simple random sampling with a 1:2 ratio; 97 cases and 194 controls were enrolled in the study. A logistic regression model was built to estimate and quantify the strength of the association between the study variables and the outcome; a p-value less than 0.05 was considered the cut-off point for a significant statistical association.
Results: Past history of TB, CD4 count < 200 cells/µl, late clinical stages, non-employment, and no formal education were found to be risk factors for developing TB among HIV-infected patients. The adjusted ORs and 95% CIs were (6.9: 3.75-12.99), (4.8: 1.57-15.26), (5.8: 1.88-17.96), (2.5: 1.26-5.03), and (2.5: 1.28-4.63), respectively. Poor adherence, marital status, age, and gender are not associated with developing TB among HIV patients.
Conclusion: HIV patients who have at least one of the risk factors found in this analysis are at higher risk of TB; therefore, they should be screened more frequently and treated promptly, especially HIV patients with previous TB.
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References

[1] Dean AS, Zignol M, Falzon D, et al. (2014) HIV and multidrug-resistant tuberculosis: overlapping epidemics. Eur Resp J 44: 251-254.

[2] Zumla A, Petersen E, Nyirenda T, et al. (2015) Tackling the tuberculosis epidemic in sub-Saharan Africa-unique opportunities arising from the second European Developing Countries Clinical Trials Partnership (EDCTP) programme 2015-2024. Int J Infect Dis 32: 46-49.

[3] Adeiza MA, Abba AA, Okpapi JU (2014) HIV-Associated tuberculosis: A sub-saharan african perspective. Sub-Sah Afr J Med 1: 1.

[4] Zumla A, George A, Sharma V, et al. (2015) The WHO 2014 Global tuberculosis report—further to go. The Lancet Global Health 3: e10-e12.

[5] Federal Ministry of Health-Sudan (2009) Provider Initiated Testing and Counselling (PITC) Report. Sudan National AIDS Control Program (SNAP).

[6] Alemayehu M, Gelaw B, Abate E, et al. (2014) Active tuberculosis case finding and detection of drug resistance among HIV-infected patients: A cross-sectional study in a TB endemic area, Gondar, Northwest Ethiopia. Intl J Mycobacter 3: 132-138.

[7] Kisembo H, Den Boon S, Davis J, et al. (2014) Chest radiographic findings of pulmonary tuberculosis in severely immunocompromised patients with the human immunodeficiency virus. Br JRadiol.

[8] Getahun H, Gunneberg C, Granich R, et al. (2010) HIV infection—associated tuberculosis: The epidemiology and the response. Clinl Infect Dis 50: S201-S207.

[9] Moore D, Liechty C, Ekwaru P, et al. (2007) Prevalence, incidence and mortality associated with tuberculosis in HIV-infected patients initiating antiretroviral therapy in rural Uganda. Aids 21: 713-719.

[10] Liu E, Makubi A, Drain P, et al. (2015) Tuberculosis incidence rate and risk factors among HIV-infected adults with access to antiretroviral therapy. AIDS (London, England) 29: 1391-1399.

[11] Bucher HC, Griffith LE, Guyatt GH, et al. (1999) Isoniazid prophylaxis for tuberculosis in HIV infection: a meta-analysis of randomized controlled trials. Aids 13: 501-507.

[12] Kufa T, Mabuto T, Muchiri E, et al. (2014) Incidence of HIV-associated tuberculosis among individuals taking combination antiretroviral therapy: a systematic review and meta-analysis.

[13] Dowdy DW, Golub JE, Saraceni V, et al. (2014) Impact of isoniazid preventive therapy for HIV-infected adults in Rio de Janeiro, Brazil: an epidemiological model. J Acqui Immune Defic Syndr (1999) 66: 552.

[14] Wacholder S, Silverman DT, McLaughlin JK, et al. (1992) Selection of controls in case-control studies: III. Design options. Am J Epidemiol 135: 1042-1050.

[15] Lawn S, Harries A, Williams B, et al. (2011) Antiretroviral therapy and the control of HIV-associated tuberculosis. Will ART do it? IntJ TubercLung Dis 15: 571.

[16] Korenromp E, Scano F, Williams B, et al. (2003) Effects of human immunodeficiency virus infection on recurrence of tuberculosis after rifampin-based treatment: an analytical review. Clin Infect Dis 37: 101-112.

[17] Kumar A, Kumar A, Gupta D, et al. (2012) Global guidelines for treatment of tuberculosis among persons living with HIV: unresolved issues [Perspectives]. Inter J Tuberc Lung Dis 16: 573-578.

[18] Lawn S, Bekker L, Wood R (2005) How effectively does HAART restore immune response to Mycobacterium Tuberculosis? Implication for tuberculosis control. AIDS Journal 20: 1113-1124.

[19] Hsu DC, Kerr SJ, Thongpaeng P, et al. (2014) Incomplete restoration of Mycobacterium tuberculosis-specific-CD4 T cell responses despite antiretroviral therapy. J Infect 68: 344-354.

[20] Badri M, Wilson D, Wood R (2002) Effect of highly active antiretroviral therapy on incidence of tuberculosis in South Africa: A cohort study. Lancet 359: 2059-2064.

[21] 21. Elliot AM, Luo N, Tembo G, et al. (1990) Impact of HIV on tuberculosis in Zambia: a cross-sectional study. BMJ 301: 412-415.

[22] WHO, CDC, IUALTD, et al. (2002) Community TB care in Africa. Report on a ‘Lesson Learned’ meeting in Harare, Zimbabwe, 27-29 September 2000.

[23] Alene KA, Nega A, Taye BW (2013) Incidence and predictors of tuberculosis among adult people living with human immunodeficiency virus at the University of Gondar Referral Hospital, Northwest Ethiopia. BMC Infect Dis 13: 292.

[24] Kassa A, Teka A, Shewaamare A, et al. (2012) Incidence of tuberculosis and early mortality in a large cohort of HIV infected patients receiving antiretroviral therapy in a tertiary hospital in Addis Ababa, Ethiopia. Trans R Soc Trop Med Hyg 106: 363-370.

[25] Ciaranello A, Lu Z, Ayaya S, et al. (2014) Incidence of World Health Organization stage 3 and 4 events, tuberculosis and mortality in untreated, HIV-infected children enrolling in care before 1 year of age: an IeDEA (International Epidemiologic Databases To Evaluate AIDS) east Africa regional analysis. Pediatr Infect Dis J 33: 623-629.

[26] Middelkoop K (2011) The effect of HIV and an Antiretroviral treatment programme on Tuberculosis transmission, incidence and prevalence in a South African Township: University of Cape Town.

[27] Pupaibool J, Limper AH (2013) Other HIV-associated pneumonias. Clin Chest Med 34: 243-254.

[28] Cagney KA, Lauderdale DS (2002) Education, wealth, and cognitive function in later life. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences 57: P163-P172.

[29] Iroezindu M, Ofondu E, Hausler H, et al. (2013) Prevalence and risk factors for opportunistic infections in HIV patients receiving antiretroviral therapy in a resource-limited setting in Nigeria. J AIDS Clinic Res S 3: 2.

[30] Sinha S, Shekhar RC, Singh G, et al. (2012) Early versus delayed initiation of antiretroviral therapy for Indian HIV-Infected individuals with tuberculosis on antituberculosis treatment. BMC Infect Dis 12: 168.

[31] Stephen Da l, Motasim B, Robina W (2005) Tuberculosis among HIV-infected patients receiving HAART: long term incidence and risk factors in a South African cohort. AIDS 19: 2019-2116.

[32] Putong N, Pitisuttithum P, Supanaranond W, et al. (2002) Mycobacterium tuberculosis infection among HIV/AIDS patients in Thailand: clinical manifestations and outcomes. Southeast Asian J Trop Med Public Health 33: 346-351.

[33] Sudre P, Hirshel B, Toscani L (1996) Risk factors for tuberculosis among HIV-infected patients in Switzerland. Eur Respir J 9: 279-283.

[34] Brussard P, Remis RS (1999) Incidence of tuberculosis among reported AIDS cases in Quebec from 1979 to 1996. JAMC 160: 1838-1842.

[35] Verma S, Dhungana G, Joshi H, et al. (2012) Prevalence of pulmonary tuberculosis among HIV infected persons in Pokhara, Nepal. J Nepal Health Research Council.

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