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  • Title: HIV sero-prevalence among tuberculosis patients in Kenya.
    Author: Van Gorkom J, Kibuga D, Adallah S, Adungosi J, Aluvaala B, Kangangi J, Kutwa A, Olewe M, Rono P, Wambua M.
    Journal: East Afr Med J; 1999 Aug; 76(8):452-6. PubMed ID: 10520351.
    Abstract:
    OBJECTIVE: To determine HIV seroprevalence among tuberculosis patients and the burden of HIV attributable tuberculosis among notified patients in Kenya. DESIGN: A cross-sectional anonymous unlinked HIV seroprevalence survey. SETTING: Tuberculosis diagnostic clinics of the National Leprosy Tuberculosis Programme in 19 districts. SUBJECTS: One thousand nine hundred and fifty-two newly notified tuberculosis patients. INTERVENTIONS: Selection and registration of eligible subjects followed by obtaining 5 ml of full blood for haemoglobin testing and separation of serum for HIV testing by ELISA. MAIN OUTCOME MEASURES: HIV seroprevalence per district and burden of HIV attributable tuberculosis among tuberculosis patients. RESULTS: A total of 1,952 eligible patients were enrolled. The weighted seroprevalence in the sample was 40.7% (range 11.8-79.6% per district). The seroprevalence was significantly higher among females and patients with sputum-smear negative tuberculosis. Chronic diarrhoea, female sex, oral thrush and a negative sputum were independent risk factors for HIV infection. The Odds ratio for HIV infection in female tuberculosis patients aged 15-44 years, was 5.6 (95% CI 4.5-6.9) compared with ante-natal clinic attenders. The population attributable risk was 0.22 in 1994. CONCLUSION: The HIV epidemic has had a profound impact on the tuberculosis epidemic in Kenya and explains about 41% of the 94.5% increase of registered patients in the period 1990-1994 and 20% of all registered patients in 1994. Repetition of the survey with inclusion of a more representative control group from the general population may provide a more accurate estimation of the burden of HIV attributable tuberculosis. This cross-sectional survey determined HIV seroprevalence among tuberculosis patients and the burden of HIV attributable tuberculosis among notified patients in Kenya. Data were collected from 1952 patients. The information gathered included demographic data, date of treatment initiation, type of patient, type of tuberculosis, sputum-smear results, and data concerning the signs and symptoms related to tuberculosis and HIV disease. Findings demonstrated that the weighted seroprevalence in the study sample was 40.7% (range, 11.8-79.6% per district), which is significantly higher in females and patients with sputum-smear negative tuberculosis. Chronic diarrhea, female sex, oral thrush, and negative sputum were independent risk factors for HIV infection. The odds ratio for HIV infection in female tuberculosis patients aged 15-44 years was 5.6 compared with antenatal clinic attenders.
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