*1Audu, E. S., 2Adiukwu, C., 3Bello, S., 4Abdulmajid, S., 4Anyuabaga, B., 5Ashuku, Y. A., and 6Anazodo, M.
1Department of Medical Microbiology/Special Treatment Clinic, Dalhatu Araf Specialist Hospital, Lafia
2Department of Internal Medicine, Dalhatu Araf Specialist Hospital, Lafia
3Department of Paediatrics/Special Treatment Clinic, Dalhatu Araf Specialist Hospital, Lafia
4Special Treatment Clinic, Dalhatu Araf Specialist Hospital, Lafia
5College of Medicine, Federal University, Lafia
6Research Unit, Dalhatu Araf Specialist Hospital, Lafia
*Correspondence to: estanamo@gmail.com
Abstract:
Background: Tuberculosis and Human Immunodeficiency Virus (HIV) co-infection is a major problem in Nigeria and other countries that are ravaged by a high burden of both diseases. The World Health Organization (WHO) reports that the risk of developing active tuberculosis (TB) among people living with HIV is 16-27 times that of HIV negative persons. Although antiretroviral therapy (ART) reduces the risk of developing TB, there are factors which predispose those on ART to TB. This study sought to determine the prevalence of TB among adults on ART in our facility and identify the predisposing factors.
Methodology: This was a retrospective study utilizing data from clinical records (folders and electronic) of adult HIV patients who are accessing ART in our facility and have been on ART for at least 6 months. A proforma was used to collect data including demographic, clinical, ART and laboratory information of the patients. The data were entered into SPSS version 23 and analyzed using descriptive statistics and bivariate analysis. Associations were tested using Chi square with 95% confidence level.
Results: A total of 457 patients were studied, aged 18-69 years (mean age 38.3± 10 years), and 72.4% females. Majority were married (81%), unemployed (53.8%), had mean baseline CD4 cell count of 267.4 ± 185 cells/mm3 and a mean duration on ART of 100.9± 39 months. Seventeen point three percent of the patients had a previous history of TB before or within 6 months of commencement of ART. Thirteen (2.8%) of the patients had active TB while on ART. Majority of those who had active TB were females (76.9%), married (76.9%), unemployed (46%), had no previous history of TB (53.8%), baseline CD4 cell count of ≤ 350 cells/mm3 and were on first line ART medication. There was however no significant statistical association of active TB with any of these factors.
Conclusion: Few patients had active TB while on ART in this study. The high frequency of TB in those who had low baseline CD4 cell count and baseline WHO stage shows the importance of early initiation of ART in people living with HIV (PLHIV). There is need for regular screening of PLHIV for TB and innovative approaches to get people with HIV to know their TB status as well as early commencement of ART.
Keywords: Human immunodeficiency virus, Active Tuberculosis, Antiretroviral therapy.
Received Dec 9, 2019; Revised March 15, 2020; Accepted March 18, 2020
Copyright 2020 AJCEM Open Access. This article is licensed and distributed under the terms of the Creative Commons Attrition 4.0 International License <a rel=”license” href=”//creativecommons.org/licenses/by/4.0/”, which permits unrestricted use, distribution and reproduction in any medium, provided credit is given to the original author(s) and the source.
Tuberculose active chez des patients adultes infectés par le VIH ayant accès à un traitement antirétroviral dans un établissement de santé tertiaire à Lafia, au centre-nord du Nigéria
*1Audu, E. S., 2Adiukwu, C., 3Bello, S., 4Abdulmajid, S., 4Anyuabaga, B., 5Ashuku, Y. A., et 6Anazodo, M. Continue reading “Active tuberculosis among adult HIV-infected patients accessing antiretroviral therapy in a tertiary health facility in Lafia, northcentral Nigeria”