Abstract
BackgroundDespite improvements in access to antiretroviral therapy (ART), mortality in people living with human immunodeficiency virus (PLHIV) is still high and primarily attributed to tuberculosis (TB) infection. In Sub-Saharan Africa, approximately 80% of HIV-related mortality cases are associated with TB. Relatively little is known about the incidence of TB among PLHIV in Tanzania and the determinant factors. We report the prevalence and incidence rate of confirmed TB and determine association with selected demographic and program-related factors based on data in the national HIV care and treatment program from 2011 to 2014.MethodsWe used the Tanzania National AIDS Control Programme database to obtain information on all HIV clients enrolled in the HIV care and treatment program between January 2011 and December 2014. We analyzed retrospective cohort data to assess the prevalence and TB incidence rate per 1000 person-years. A multivariable Cox proportional hazards regression model was used to estimate hazard ratios and 95% confidence intervals for putatively associated factors.ResultsOver 4 years, there were 22,071 confirmed cases of pulmonary TB in 1,323,600 person-years. The overall TB incidence was around 16.7 (95% CI 16.4–16.9) cases per 1000 person-years. The annual incidence rate decreased by 12.4 % from 17.0 (95% CI 16.5–17.4) in 2011 to 14.9 (95% CI 14.5–15.4) in 2014. The TB incidence rate was higher in persons not using ART and in males than in females. The incidence of TB was higher in patients with advanced HIV disease and decreased with increasing age. The overall prevalence of TB was 2.2%, with a peak prevalence of 2.5% in 2013 and was higher among children < 15 years (3.2%) in the same year.ConclusionThe study found an overall decrease in the incidence of TB in PLHIV. Our results emphasize the need for early initiation of ART and the provision of TB preventive therapy for those PLHIV without active TB after intensified TB case-finding.
Highlights
Tuberculosis (TB) and human immunodeficiency virus (HIV) co-infection is a significant public health problem worldwide [1,2,3]
Data were extracted and analyzed from records of 527, 249 individuals with a total of 11,539,844 clinical encounters enrolled in HIV care and treatment services between 2011 and 2014, with an average of 6 encounters per year (Table 1)
We conducted an assessment of the occurrence of a first episode of pulmonary tuberculosis (PTB), involving individuals whose first visits at HIV care and treatment services occurred between January 2011 and December
Summary
Tuberculosis (TB) and human immunodeficiency virus (HIV) co-infection is a significant public health problem worldwide [1,2,3]. The National Tuberculosis and Leprosy Programme annual report of 2017 indicates that about 31% of all TB-notified cases had co-infection with HIV [6]. Despite the increased access to antiretroviral therapy (ART), mortality in PLHIV is still high, and TB is the leading cause of mortality [7,8,9]. Despite improvements in access to antiretroviral therapy (ART), mortality in people living with human immunodeficiency virus (PLHIV) is still high and primarily attributed to tuberculosis (TB) infection. We report the prevalence and incidence rate of confirmed TB and determine association with selected demographic and program-related factors based on data in the national HIV care and treatment program from 2011 to 2014
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
