Abstract
BackgroundThe impact of HIV on TB, and the implications for TB control, has been acknowledged as a public health challenge. It is imperative therefore to assess the burden of HIV on TB patients as an indicator for monitoring the control efforts of the two diseases in this part of the world. This study aimed at determining the burden of HIV infection in TB patients.MethodsWe conducted a retrospective review of TB registers in five districts of the Volta Region of Ghana. Prevalence of TB/HIV co-infection was determined. Bivariate and multivariate logistic regression were used to identify the predictors of HIV infection among TB patients and statistical significance was set at p-value <0.05.ResultsOf the 1772 TB patients, 1633 (92.2%) were tested for HIV. The overall prevalence of TB/HIV co-infection was (18.2%; 95% CI: 16.4–20.1). The prevalence was significantly higher among females (24.1%; 95%CI: 20.8–27.7), compared to males (15.1%; 95% CI: 13.1–17.4) (p < 0.001) and among children <15 years of age (27.0%; 95% CI: 18.2–38.1), compared to the elderly ≥70 years (3.5%; 95% CI: 1.6–7.4) (p < 0.001). Treatment success rate was higher among patients with only TB (90%; 95% CI: 88.1–91.5) than among TB/HIV co-infected patients (77.0%; 95% CI: 71.7–81.7) (p < 0.001). Independent predictors of HIV infection were found to be: being female (AOR: 1.79; 95% CI: 1.38–2.13; p < 0.001); smear negative pulmonary TB (AOR: 1.84; 95% CI: 1.37–2.47; p < 0.001); and patients registered in Hohoe, Kadjebi, and Kpando districts with adjusted odds ratios of 1.69 (95% CI: 1.13–2.54; p = 0.011), 2.29 (95% CI: 1.46–3.57; p < 0.001), and 2.15 (95% CI: 1.44–3.21; p < 0.001) respectively. Patients ≥70 years of age and those registered in Keta Municipal were less likely to be HIV positive with odds ratios of 0.09 (95% CI: 0.04–0.26; p < 0.001) and 0.62 (95% CI: 0.38–0.99; p = 0.047) respectively.ConclusionTB/HIV co-infection rate in five study districts of the Volta region is quite high, occurs more frequently in female patients than males; among smear negative pulmonary TB patients, and children <15 years of age. Findings also demonstrate that HIV co-infection affects TB treatment outcomes adversely. Strengthening the TB/HIV collaborative efforts is required in order to reduce the burden of co-infection in patients.
Highlights
The impact of Human immuno-deficiency Virus (HIV) on TB, and the implications for TB control, has been acknowledged as a public health challenge
Findings demonstrate that HIV co-infection affects TB treatment outcomes adversely
Strengthening the TB/HIV collaborative efforts is required in order to reduce the burden of co-infection in patients
Summary
The impact of HIV on TB, and the implications for TB control, has been acknowledged as a public health challenge. Tuberculosis (TB) has existed for years and remains a major global public health problem. It causes ill-health in millions of people each year and in the year 2015, TB was among the top 10 causes of death worldwide, ranking above Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS) as one of the leading causes of death from an infectious disease [1]. The 2015 estimates of the World Health Organization (WHO) showed that there were 10.4 million incident cases of TB worldwide of which, about 10% were coinfected with Human immuno-deficiency Virus (HIV) and about 1.4 million deaths, of which, 400,000 deaths were among people co-infected with HIV [1]. 32% of TB cases were estimated to be co-infected with HIV in this region, which represents 74% of TB cases among people living with HIV worldwide [1]
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