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Etiologic agents of lower respiratory tract infections among patients attending tuberculosis clinic in Benin City, Nigeria

E.E. Ibadin, H.O. Ogefere, T.O. Ehondor

 

Abstract

The emergence of HIV has reawakened the tuberculosis (TB) scourge and infected patients are prone to opportunistic infections, this study was carried out to determine the HIV status and etiologic agents of Lower respiratory tract infections (LRTI) among tuberculosis suspected patients in Benin City, Nigeria. The study was cross sectional. A total of 276 patients attending tuberculosis clinic were recruited. Questionnaires were filled for each patient. Blood and sputum specimens were collected in plain and sterile containers respectively and transported immediately to the laboratory. Blood samples were screened for the presence of HIV antibodies. The sputum specimens were then cultured following standard microbiological procedure, and thereafter processed using the GeneXpert MTB/RIF assay. Emergent bacterial colonies were identified and susceptibility testing was carried out following standard microbiological techniques. A total of 118 (42.8%) non-mycobacterial bacterial agents were recovered from the patients. Patients were more likely to be culture positive for LRTI in comparison with TB infection (p < 0.0001). There was no association between TB and HIV status (OR = 0.6161, 95%CI = 0.226, 1.648, p = 0.4474). HIV positive patients were more likely to be culture positive for bacterial agents and Klebsiella pneumoniae was more likely to be recovered (p = 0.0338). The fluoroquinolones, gentamicin and ceftriaxone-sulbactam were the most active antibacterial agents against bacterial isolates. The prevalence of LRTI in this study was 52.2%. The study draws attention on the need for physicians to request for bacteriological culture (non-mycobacterial) alongside the TB diagnostic algorithm in suspected TB cases.

Keywords: Tuberculosis, HIV, opportunistic infections, patients, bacteria

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Etiologic agents of lower respiratory tract infections among patients attending tuberculosis clinic in Benin City, Nigeria

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Opportunistic infections and clinico-epidemiological factors in HIV/AIDS casesseen in a tertiary care hospital in Nepal

RN Das, HS Joshi, R Biswas, HS Joshi

 

Abstract

Opportunistic infections are the leading cause of morbidity and mortality among HIV/AIDS patients. The spectrum of opportunistic pathogens involved in such infections in Nepal is not well documented. A cross sectional (hospital-based) study was carried out at the AIDS clinic of Manipal Teaching Hospital, Pokhara, Nepal. A total of 404 clinically suspected cases of HIV/AIDS seen at the clinic between July 2001 and December 2002, were screened for HIV. Seventy four (18.3%) were sero-positive for HIV. Fever was the commonest presenting symptoms 48.6% followed by cough and dyspnoea 36.5%, weight loss 36.5% and pulmonary tuberculosis 21.6%. Fifty five of the 74 (74.3%) HIV positive cases were in the age group 20-39 years. Heterosexual mode of acquisition/transmission was seen in 60.8% and 21.6% were intravenous drug abusers (IVDA). A total of 45 opportunistic pathogenic isolates were recovered from the 74 patients. Mycobacterium tuberculosis was the commonest pathogen 60%, followed by Cryptosporidium spp 13.3% and Candida spp 11.1%. Four patients died during the period of study giving a mortality rate of 5.4%. This study shows that HIV/AIDS is rapidly becoming a grave concern in the Pokhara valley of Nepal. Intensive and effective health education programmes among the target population may be a cost effective method to curb the rising prevalence of HIV/AIDS in a developing country like Nepal. Also, further regional studies are required to establish more detailed epidemiological database of opportunistic infections in HIV/AIDS patients in Nepal.

Keywords: HIV/AIDS, opportunistic infections, Nepal

African Journal of Clinical and Experimental Microbiology Vol. 6 (3) 2005: 239-245