Ligidi, Tadesse (2008) Prevalence of Human Immunodeficiency Virus (HIV) Infection and Immune Status in Newly Diagnosed Adult Tuberculosis Patients in Adama Hospital, Ethiopia. Masters thesis, Addis Ababa University.
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Abstract
Tuberculosis (TB) is a major public health problem disproportionally affecting the low income countries. It is estimated that one third of the world’s population is latently infected with mycobacterium tuberculosis (MTB).Each year; 8 million cases of active TB with over 2 million deaths are estimated to occur globally. The vast majority of individuals with TB live in Africa, South-East Asia and Western Pacific regions. TB and HIV form a lethal combination, each speeding the other's progress. Globally the number of people living with HIV continues to grow, as does the number of deaths due to acquired immunodeficiency syndrome (AIDS). A total of 39.5 million (34.1million –47.1million) people were living with HIV in 2006 of which about two-thirds live in sub Saharan Africa. Sub-Saharan Africa thus bears the overwhelming burden of the HIV/AIDS epidemic and TB. The aim of this study was to determine the prevalence of HIV infection and assess the immune status of newly diagnosed untreated tuberculosis patients. Sample of blood from 258 patients aged 18 and 70 years was collected and screened for HIV by rapid HIV test kits according to the country national testing algorithm. The CD4+ T cell count of each patient was also performed after collecting 4 ml whole blood to k3EDTA tube using fluorescent activated cell sorter (FACS count- Becton Dickinson-USA) and expressed as cells/mm3. Out of the total 258 specimens, 68 (26.4%) were found to be positive for HIV antibodies. The prevalence was 28.8% (36/125 ) in females and 24.1%(32/133)in males. The prevalence was high in urban patients (37.9%) than rural (15.7%) (p=0.00), in divorced and widowed patients (65% and 55% respectively) than married TB patients (21.3%) (p=0.00). Occupationally, government employees were the most affected group of new TB patients by HIV. The findings suggest that higher risk of HIV co-infection is present among urban residents, divorced TB patients and government employees. Type of clinical TB, educational status of patients and sex has no association with HIV infection in TB patients. Of all 68 study participants found HIV positive, only 14.7% knew their HIV sero status before the study (pre ART patients) and the remained around 85% do not know their status, so learned it from the study. The median CD4+ T-cell count was 233 cells/mm3for those newly diagnosed TB who tested positive for HIV during this study and 295 for the pre ART patients. The median count was significantly higher in HIV negative TB patients (702 cells/mm3, p=0.00) than HIV positives. Large proportion of newly diagnosed HIV positive TB patients who did not know their HIV status prior to this study had CD4+T –cell count<200 cells//mm3, account which could have made them eligible for ART. In this regard, the provider initiative counseling and testing (PICT) recently started in health institutions, especially in TB clinics should have to be appreciated and strengthened. In conclusion, HIV sero prevalence in TB patients is a sensitive indicator of the spread of HIV into the general population and this information is essential to respond to the increasing commitment to provide comprehensive HIV/AIDS care and support among the high risk groups identified, including antiretroviral therapy (ART) to HIV-positive TB patients. Therefore, the study will give an understanding of the epidemiological relationship between HIV and TB diseases at the community level in Adama town and the surrounding villages.
| Item Type: | Thesis (Masters) |
|---|---|
| Uncontrolled Keywords: | Tuberculosis, HIV/AIDS, Immune status, prevalence, pathogenesis |
| Subjects: | Q Science > QR Microbiology Q Science > QR Microbiology > QR180 Immunology R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine |
| Divisions: | Africana |
| Depositing User: | Emmanuel Ndorimana |
| Date Deposited: | 10 Aug 2018 12:12 |
| Last Modified: | 10 Aug 2018 12:12 |
| URI: | http://thesisbank.jhia.ac.ke/id/eprint/8103 |
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