Prevalence and incidence rate of tuberculosis among HIV-infected patients enrolled in HIV care, treatment, and support program in mainland Tanzania.
Antiretroviral therapy
Collaborative TB/HIV
HIV
Incidence of tuberculosis
Tuberculosis
Journal
Tropical medicine and health
ISSN: 1348-8945
Titre abrégé: Trop Med Health
Pays: Japan
ID NLM: 101215093
Informations de publication
Date de publication:
04 Sep 2020
04 Sep 2020
Historique:
received:
30
03
2020
accepted:
24
08
2020
entrez:
13
2
2021
pubmed:
14
2
2021
medline:
14
2
2021
Statut:
epublish
Résumé
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. 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. We 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. Over 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. The 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.
Sections du résumé
BACKGROUND
BACKGROUND
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. 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.
METHODS
METHODS
We 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.
RESULTS
RESULTS
Over 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.
CONCLUSION
CONCLUSIONS
The 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.
Identifiants
pubmed: 33579394
doi: 10.1186/s41182-020-00264-1
pii: 10.1186/s41182-020-00264-1
pmc: PMC7818072
doi:
Types de publication
Journal Article
Langues
eng
Pagination
76Références
Wkly Epidemiol Rec. 2004 Jan 9;79(1-2):6-11
pubmed: 14746111
AIDS. 2003 May 23;17(8):1201-8
pubmed: 12819522
AIDS. 2010 Jul 31;24(12):1849-55
pubmed: 20622529
Lancet. 2002 Jun 15;359(9323):2059-64
pubmed: 12086758
Braz J Infect Dis. 2008 Aug;12(4):281-6
pubmed: 19030726
PLoS One. 2015 Nov 09;10(11):e0142290
pubmed: 26551023
J Int Assoc Physicians AIDS Care (Chic). 2009 May-Jun;8(3):170-5
pubmed: 19246416
Int J Tuberc Lung Dis. 2010 Mar;14(3):318-23
pubmed: 20132623
AIDS. 2005 Dec 2;19(18):2109-16
pubmed: 16284460
PLoS One. 2014 Nov 13;9(11):e111209
pubmed: 25393281
BMC Health Serv Res. 2017 Aug 7;17(1):540
pubmed: 28784131
Int J Tuberc Lung Dis. 2008 Nov;12(11):1336-9
pubmed: 18926047
PLoS One. 2017 Mar 30;12(3):e0173976
pubmed: 28358846
AIDS. 2013 May 15;27(8):1273-81
pubmed: 23343909
AIDS. 2008 Oct 1;22(15):1897-908
pubmed: 18784453
Rev Saude Publica. 1997 Aug;31(4):323-9
pubmed: 9595761
J Biol Regul Homeost Agents. 2001 Jul-Sep;15(3):218-23
pubmed: 11693427
AIDS. 2015 Jul 17;29(11):1391-9
pubmed: 26091295
Arch Intern Med. 2007 Dec 10;167(22):2443-52
pubmed: 18071166
AIDS. 2000;14 Suppl 3:S47-56
pubmed: 11086849
J Epidemiol Community Health. 2015 Jun;69(6):568-73
pubmed: 25605864
AIDS Res Hum Retroviruses. 2013 Jun;29(6):931-7
pubmed: 23316724
PLoS One. 2013;8(1):e54665
pubmed: 23349948
AIDS. 1998 Dec 24;12(18):2447-57
pubmed: 9875583
AIDS. 2001 Nov 9;15(16):2129-35
pubmed: 11684932
Can J Infect Dis Med Microbiol. 2007 Sep;18(5):289-91
pubmed: 18923728
Int J Infect Dis. 2010 Feb;14(2):e127-31
pubmed: 19632872
Thorax. 2006 Apr;61(4):348-53
pubmed: 16449260
AIDS. 2004 Sep 24;18(14):1933-41
pubmed: 15353979
Mem Inst Oswaldo Cruz. 1999 May-Jun;94(3):377-81
pubmed: 10348986
Ethiop J Health Sci. 2011 Jul;21(2):131-9
pubmed: 22434992