BMC Infectious Diseases | |
Incidence and predictors of tuberculosis among adult people living with human immunodeficiency virus at the University of Gondar Referral Hospital, Northwest Ethiopia | |
Belaynew Wasie Taye3  Ansha Nega1  Kefyalew Addis Alene2  | |
[1] Department of Environmental and Occupational Health and Safety, Institute of Public Health, College of Medicine and Health Sciences, The University of Gondar, P.O.Box 196, Gondar, Ethiopia;Department of Health Officer, Institute of Public Health, College of Medicine and Health Sciences, The University of Gondar, Gondar, Ethiopia;Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, The University of Bahirdar, P.O.Box 79, Bahirdar, Ethiopia | |
关键词: Gondar; Predictors; Incidence; HIV Infection; Tuberculosis; | |
Others : 1147512 DOI : 10.1186/1471-2334-13-292 |
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received in 2012-08-15, accepted in 2013-06-20, 发布年份 2013 | |
【 摘 要 】
Background
Tuberculosis (TB) is the leading killer of people living with HIV (PLHIV). Many of these deaths occur in developing countries. This study aimed at determining the incidence and predictors of tuberculosis among PLHIV.
Methods
A five year retrospective follow up study was conducted among adult PLHIV. The Cox proportional hazards model was used to identify predictors.
Results
A total of 470 patients were followed and produced 1724.13 Person-Years (PY) of observation, and 136 new TB cases occurred during the follow up period. The overall incidence density of TB was 7.88 per 100 PY. It was high (95.9/100PY) in the first year of enrolment. The cumulative proportion of TB- free survivals was 79% and 67% at the end of the first and fifth years, respectively. Baseline WHO clinical stage III (AHR = 2.88, 95% CI = 1.53-5.43), WHO clinical stage IV (AHR = 3.82, 95% CI = 1.86-7.85), CD4 count <50 cell/ul (AHR = 2.13, 95% CI = 1.28-3.53) and ambulatory or bed ridden functional status (AHR = 1.64, 95%CI = 1.13-2.38) were predictors of time to TB occurrence.
Conclusions
TB incidence rate among PLHIV, especially in the first year of enrollment was high. Advanced WHO clinical stage, limited functional status, and low CD4 count (<50 cell cell/ul) were found to be the independent predictors of TB occurrence. Early care seeking and initiation of HAART to improve the CD4 count and functional status are important to reduce the risk of TB infection.
【 授权许可】
2013 Addis Alene et al.; licensee BioMed Central Ltd.
【 预 览 】
Files | Size | Format | View |
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20150404013204656.pdf | 526KB | download | |
Figure 3. | 29KB | Image | download |
Figure 2. | 38KB | Image | download |
Figure 1. | 22KB | Image | download |
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【 参考文献 】
- [1]Corbett E, Marston B, Churchyard G, Cock KD: Tuberculosis in sub-Saharan Africa: opportunities, challenges, and change in the era of antiretroviral treatment. Lancet 2006, 367:926-937.
- [2]Reid A, Scano F, Getahun H, Williams B, Dye C, Nunn P: Towards universal access to HIV prevention, treatment, care, and support: the role of tuberculosis/HIV collaboration. Lancet Infect Dis 2006, 6:483-495.
- [3]WHO: Priority research questions for TB/HIV in HIV-prevalent and resource-limited settings. Geneva, Switzerland; 2010.
- [4]FMOH: Tuberculosis, Leprosy, and TB/HIV prevention and control programme manual. Fourth edition edition. Addis Abeba, Ethiopia; 2008:71-74.
- [5]Jamison T, Feachem G, Makgoba W, Bos R, Baingana K, Hofman J: Disease and Mortality in Sub-Saharan Africa. second edition. Washington: World Bank; 2006.
- [6]Anthony F, Dan L, Eugene B, Dennis K, Stephen H, Larry J, Loscalzo J: Harrison’s Principles of internal medicine vol. one Seventeenth edn. McGraw-Hill Companies: United States of America; 2008.
- [7]Kent M, Yin S: Controlling Infectious Diseases, vol. 1. Washington: Mary Mederios Kent; 2006.
- [8]Burman W, Weis S, Vernon A: Frequency, severity and duration of immunereconstitution events in HIV-related tuberculosis. Int J Tuberc Lung Dis 2007, 11:1282-1289.
- [9]Lorent N, Sebatunzi O, Mukeshimana G, Ende JV, Clerinx J: Incidence and risk factors of serious adverse events during antituberculous treatment in Rwanda: a prospective cohort study. J Acquir Immune Defic Syndr 2011, 58(1):32-37.
- [10]Breen R, Smith C, Bettinson H: Paradoxical reactions during tuberculosis treatment in patients with and without HIV co-infection. Thorax Aug 2004, 59(8):704-707.
- [11]Havlir D, Kendall M, Ive P, Kumwenda J, Swindells S, Qasba S: Timing of Antiretroviral Therapy for HIV-1 Infection and Tuberculosis. N Engl J Med 2011, 365:482-491.
- [12]Deribew A, Tesfaye M, Hailmichael Y, Negussu N, Daba S, Wogi A, Belachew T, Apers L, Colebunders R: Tuberculosis and HIV co-infection: its impact on quality of life. Health Qual Life Outcomes 2009, 7:105. 2009 BioMed Central Full Text
- [13]Deribew A, Tesfaye M, Hailmichael Y, Apers L, Abebe G, Duchateau L, Colebunders R: Common mental disorders in TB/HIV co-infected patients in Ethiopia. BMC Infect Dis 2010, 10:201. BioMed Central Full Text
- [14]World Health Organization (WHO): WHO Global TB Report, Ethiopian tuberculosis profile. Addis Abeba, Ethiopia: WHO Ethiopia; 2009.
- [15]Ngowi B, Mfinanga S, Bruun J, Morkve O: Pulmonary tuberculosis among people living with HIV/AIDS attending care and treatment in rural northern Tanzania. BMC Publ Health 2008, 8:341. BioMed Central Full Text
- [16]Iliyasu Z, Babashani M: Prevalence and Predictors of Tuberculosis Coinfection among HIV-Seropositive Patients Attending the Aminu Kano Teaching Hospital, Northern Nigeria. J Epidemiol 2009, 19(2):81-87.
- [17]Assefa D, Melaku Z, Gadissa T, Negash A, Hinderaker S, Harries A: Intensified tuberculosis case finding among people living with the human immunodeficiency virus in a hospital clinic in Ethiopia. Int J Tuberc Lung Dis 2011, 15(3):411-413.
- [18]Marianne A, Sande B, Maarten F, Loeffa S, Bennett R: Incidence of tuberculosis and survival after its diagnosis in patients infected with HIV-1 and HIV-2. Lippincott Williams & Wilkins 2004, 18:3-4.
- [19]Bonnet M, Pinoges L, Varaine F, Oberhauser B, O’Brien D, Kebede Y: Tuberculosis after HAART initiation in HIV-positive patients from five countries with a high tuberculosis burden. AIDS 2006, 20(9):1275-1279.
- [20]Brinkhof M, Egger M, Boulle A: Tuberculosis after initiation of antiretroviral therapy in low-income and high-income countries. Clin nfect Dis 2007, 45:1518-1521.
- [21]Stephen D, Wilkinson R, Lipman M, Wood R: Immune Reconstitution and “Unmasking” of Tuberculosis during Antiretroviral Therapy. Am J Respir Crit Care Med 2008, 177(7):680.
- [22]Stephen D, Wilkinson RJ, Marc C, Robin W, Respir J, et al.: Pulmonary Perspective Immune Reconstitution and “Unmasking” of Tuberculosis during Antiretroviral Therapy. Respir Crit Care Med 2008, 177:680-685.
- [23]Jerene D, Næss A, Lindtjørn B: Antiretroviral therapy at a district hospital in Ethiopia prevents death and tuberculosis in a cohort of HIV patients. AIDS Res Ther 2006, 3:10. BioMed Central Full Text
- [24]Tseng S-H, Jiang D, Hoi H-S: Short Report: Impact of HAART Therapy on Co-Infection of Tuberculosis and HIV Cases for 9 Years in Taiwan. AmJTrop Med Hyg 2009, 80(4):675-677.
- [25]Golub JE, Saraceni V, Cavalcante SC, Pacheco AG, Moulton LH, King BS: The impact of antiretroviral therapy and isoniazid preventive therapy on tuberculosis incidence in HIV-infected patients in Rio de Janeiro, Brazil. AIDS 2007, 21(11):1441-1448.
- [26]Sterling T, Lau B, Zhang J, Aimee F, Bosch R, Brooks J: Risk Factors for Tuberculosis After Highly ActiveAntiretroviral Therapy Initiation in the United States and Canada: Implications for Tuberculosis Screening. Infect Dis Soc Am 2011, 204:896-898.
- [27]Seyler C, Toure S, Messou E, Bonard D, Gabillard D, Anglaret X: Risk factors for active tuberculosis after antiretroviral treatment initiation in Abidjan. Am J Respir Crit Care Med 2005, 172:123-127.