TB/HIV Coinfection and Other Medical Co-Morbidity in Older Adults (50 - 64 Years) in Botswana: Evidence from 2013 Botswana AIDS Impact Survey (BAIS IV)

Njoku Ola Ama,Helen Aforji Ama,Francis Nathan Okurut

doi:10.4236/asm.2019.93004

Abstract

Background: Many older adults (50 - 64 years) in Botswana with HIV do not know they are infected with TB. Some with TB disease are unaware of their HIV status, yet HIV/TB coinfection is high. The study aims to determine the prevalence of TB among older adults with HIV, their HIV/AIDS knowledge and vulnerability to hypertension, diabetes and asthma using the 2013 BAIS IV data. Material and Methods: The BAIS IV study, from which the data for this article is derived, used a stratified two-stage probability sampling design. The first stage was the selection of 297 Enumeration Areas (EAs) as Primary Sampling Units and second stage was selection of households (5,415) in the EAs. The study targeted all usual members of the selected households aged 6 weeks and above for the Biomarker or testing for HIV and those aged 10 - 64 years old for the behavioral questionnaire. Results: The study shows that the older adults (50 - 64 years) with TB have a low level of education and HIV prevalence is very high (44% for age 50 - 54, 40.6% for age 55 - 59 and 68.4% for age 60 - 64 years). The rate of HIV/TB coinfection, 21.9%, is high and prevalence of TB among the older adults is 8.6% (13%, males and 5.3%, females) while only 0.8% are currently on treatment. Only 67.2% know that if a pregnant mother is infected with HIV, there is a way of preventing transmission of the virus to the child. Age, level of education, marital status and employment status significantly (p < 0.01) predict TB diagnosis and treatment. Conclusion: The study concludes that lower education seems to be an obstacle to accessing TB treatment. Therefore, older adults’ awareness and knowledge of the symptoms of both diseases (TB and HIV), mode of infection and treatment need to adequately improve through increased education to overcome health challenges when infected with asthma, diabetes and high blood pressure/hypertension.

Highlights

Tuberculosis (TB) is the largest single cause of death in the setting of AIDS [1] accounting for about 26% of AIDS-related deaths [2], 99% of which occur in developing countries [3]
67.2% know that if a pregnant mother is infected with HIV, there is a way of preventing transmission of the virus to the child
The study concludes that lower education seems to be an obstacle to accessing TB treatment

Summary

Introduction

Tuberculosis (TB) is the largest single cause of death in the setting of AIDS [1] accounting for about 26% of AIDS-related deaths [2], 99% of which occur in developing countries [3]. The study aims to determine the prevalence of TB among older adults with HIV, their HIV/AIDS knowledge and vulnerability to hypertension, diabetes and asthma using the 2013 BAIS IV data. Results: The study shows that the older adults (50 - 64 years) with TB have a low level of education and HIV prevalence is very high (44% for age 50 - 54, 40.6% for age 55 - and 68.4% for age - 64 years).

Objectives

Methods

Results

Discussion

Conclusion