Tuberculosis and HIV infection association in a rural district of northern Uganda: epidemiological and clinical considerations

Migliori, Giovanni Battista; Borghesi, A.; Adriko, C.; Manfrin, Vinicio; Okware, Samuel; Naamara, Warren; Bartoloni, Alessandro; Neri, Monica; Acocella, G

doi:10.1016/0962-8479(92)90134-6

Cited by 20 publications

(7 citation statements)

References 16 publications

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“…), has been found in previous studies (Kelly et al, 1990;Elliott et al, 1993), and accords with HIV seroprevalences in the population as a whole. As in the present study, Migliori et al (1992) also found that more of those with HIV infection were male than female, although this result is inconsistent with those of some other studies (Kelly et al, 1990;Nunn et al, 1992). Although pulm onary/smear-positive disease was less comm on and pleural effusion and lymphadenopathy more common in the HIVpositive patients than in the HIV-negative, these differences were not signi® cant; similar observations were made in Kenya by Nunn et al (1992).…”

Section: Discussioncontrasting

confidence: 89%

“…Although pulm onary/smear-positive disease was less comm on and pleural effusion and lymphadenopathy more common in the HIVpositive patients than in the HIV-negative, these differences were not signi® cant; similar observations were made in Kenya by Nunn et al (1992). While bone/joint TB accounted for 25% of EPTB in East Africa in the 1960s and 1970s (Harries, 1994), it was not a common ® nding in the present HIV-positive patients or in those studied elsewhere in sub-Saharan Africa (Wadhawan and Hira, 1989;Kelly et al, 1990;Migliori et al, 1992;Nunn et al, 1992).…”

Section: Discussionsupporting

confidence: 73%

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The scourge of HIV related tuberculosis: a cohort study in a district general hospital in Malawi

Harries

Nyangulu

Kang'ombe

et al. 1997

Annals of Tropical Medicine And Parasitology

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Malawi is similar to a number of other African countries in having an escalating, HIV-related, tuberculosis (TB) epidemic. A prospective study was carried out to determine the pattern of disease and HIV serostatus in unselected, adult, TB patients consecutively admitted to a large, district general hospital in Zomba (in the Southern region of Malawi). Clinical details were obtained, from the district TB register, for the 714, adult TB patients, aged > or = 15 years, who were registered with the district TB officer between 1 July and 31 December in 1995. Patients were counselled, and offered HIV testing using an ELISA and particle agglutination test. Concordant HIV-test results were available for 686 (96%) of the subjects: 547 (80%) of these were HIV-seropositive and 139 seronegative. The HIV-positive patients were significantly younger than the HIV-negative patients and significantly more HIV-positive patients were males (P < 0.05 for each). The proportions of HIV-positive subjects who were new patients, had been previously treated for TB, had pulmonary TB (PTB), had smear-positive PTB or had different types of extrapulmonary TB were similar to those of the HIV-negative. A high percentage of an unselected cohort of adult TB patients admitted to a district, general hospital in Malawi, particularly of the younger age groups was therefore HIV-positive. The pattern of disease was uninfluenced by the HIV serostatus. The large number of cases registered emphasises the severity of the current epidemic of TB in Malawi and its impact upon young adults.

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Section: Discussioncontrasting

confidence: 89%

Section: Discussionsupporting

confidence: 73%

The scourge of HIV related tuberculosis: a cohort study in a district general hospital in Malawi

Harries

Nyangulu

Kang'ombe

et al. 1997

Annals of Tropical Medicine And Parasitology

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“…Our findings are in accord with results of a recent study conducted in Uganda. The study from Uganda, a country where the epidemic has entered a plateau phase, found no association between severe adverse reactions to medications and HIV infection in tuberculosis patients [38].…”

Section: Discussionmentioning

confidence: 99%

The cost to health services of human immunodeficiency virus (HIV) co-infection among tuberculosis patients in Sudan

El-Sony¹

2006

Health Policy

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“…Even if the problems encountered in planning, organizing and running the survey might have in some way affected the results, our study provided the following answers: 1) the ARTI in Uganda is 1.2% for 1987 and 1.1% for 1990, with an annual decrease from 0.8% (1958-1970) to 2.94% (1970-1987); 2) the estimated incidence of smear positive TB cases in 1990 is 53 per 100,000 population, while the smear negative/extrapulmonary TB cases incidence is 65 per 100,000; and 3) the overall notification rate in 1990 is 68%. A good surveillance system is, therefore, an essential instrument in monitoring the TB situation, with the ultimate goal of achieving TB control [24]. In view of the impact of the HIV pandemic on TB prevalence in Uganda, adequate surveillance remains a basic step to limit the spread of TB in sub-Saharan Africa [33].…”

Section: Discussionmentioning

confidence: 99%

Risk of infection and estimated incidence of tuberculosis in northern Uganda

Gb¹,

Borghesi²,

Spanevello³

et al. 1994

Eur Respir J

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The main goals of our study were to evaluate: 1) the annual risk of tuberculosis infection (ARTI) and its annual decrease in Uganda; 2) the expected incidence of new tuberculosis cases and the notification rate; and 3) the role of incentives given to children tested in increasing compliance with the survey procedures. The methodology is based on performing the standard World Health Organization (WHO) tuberculin test on children of the same age groups at intervals of 10-15 yrs, identifying infected persons by induration distribution analysis, and converting the prevalence rates detected into risk rates according to the ARTI model. Two thousand six hundred and twenty one school children aged 10 yrs old and bacilli Calmette-Guerin (BCG) nonvaccinated, in six study areas, were injected with two tuberculin units (TU) of purified protein derivative (PPD) RT 23 Copenhagen. The detected prevalence was 14 +/- 1.4% (prevalence +/- 95% confidence interval (95% CI)) and the ARTI value 1.2 +/- 0.9%, with an estimated annual decrease of 0.83% from 1958 to 1970 and 2.9% in the 1970-1987 period. The estimated expected incidence of new cases in Uganda was 59 smear positive and 75 smear negative/extrapulmonary cases per 100,000 population in 1987, and 53 and 65, respectively, in 1990, with an overall 68% notification coverage. No significant improvement in children returning for reading was observed in the group receiving incentives. We conclude that the average decrease (2.9%) probably represents the natural decline of tuberculosis in Uganda. The coverage appears encouraging, although the ARTI detected could be underestimated, since the existing ARTI model was developed and validated before the human immunodeficiency virus (HIV) era.(ABSTRACT TRUNCATED AT 250 WORDS)

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Tuberculosis and HIV infection association in a rural district of northern Uganda: epidemiological and clinical considerations

Cited by 20 publications

References 16 publications

The scourge of HIV related tuberculosis: a cohort study in a district general hospital in Malawi

The scourge of HIV related tuberculosis: a cohort study in a district general hospital in Malawi

The cost to health services of human immunodeficiency virus (HIV) co-infection among tuberculosis patients in Sudan

Risk of infection and estimated incidence of tuberculosis in northern Uganda

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