CROSS-SECTIONAL SURVEY OF HIV-INFECTION AMONG PATIENTS WITH TUBERCULOSIS IN NAIROBI, KENYA

被引:65
作者
NUNN, P
GICHEHA, C
HAYES, R
GATHUA, S
BRINDLE, R
KIBUGA, D
MUTIE, T
KAMUNYI, R
OMWEGA, M
WERE, J
MCADAM, K
机构
[1] KENYA GOVT MED RES CTR,NAIROBI,KENYA
[2] KENYATTA NATL HOSP,HOSP INFECT DIS,NAIROBI,KENYA
[3] UNIV LONDON LONDON SCH HYG & TROP MED,LONDON WC1E 7HT,ENGLAND
[4] PUBL HLTH LAB,OXFORD,ENGLAND
[5] NATL PUBL HLTH LABS,TB LAB,NAIROBI,KENYA
来源
TUBERCLE AND LUNG DISEASE | 1992年 / 73卷 / 01期
基金
英国惠康基金;
关键词
D O I
10.1016/0962-8479(92)90079-Y
中图分类号
R56 [呼吸系及胸部疾病];
学科分类号
摘要
Evidence from many countries suggests an association of human immunodeficiency virus (HIV) infection and tuberculosis of major public health significance. In order to begin assessing the impact of HIV on tuberculosis in Kenya, we have determined the HIV-1 seroprevalence among tuberculosis patients and compared the clinical characteristics of tuberculosis in HIV-positive and HIV-negative patients in two cross-sectional studies at the Infectious Disease Hospital (IDH) and the Ngaira Avenue Chest Clinic (NACC), Nairobi, Kenya. The diagnosis in 92% of all patients with pulmonary tuberculosis was confirmed by culture. The remainder were diagnosed on histological, clinical or radiological grounds. HIV seroprevalence among tuberculosis patients at IDH was 26.5% (52/196) compared to 9.2% (18/195) at NACC (p < 0,001). There was no association between numbers of streptomycin injections in the previous 5 years and HIV infection. Positive sputum smear rates in HIV-positive patients were slightly lower than in HIV-negative patients at both study sites (71% vs 83% at IDH and 73% vs 82% at NACC) but the difference was not significant. Only Mycobacterium tuberculosis was isolated. Miliary disease was not associated with HIV infection. Persistent diarrhoea, oral candidiasis, generalized itchy rash, herpes zoster and generalized lymphadenopathy were all associated with HIV infection, but 46% (95% CI:38-54%) of all HIV-positive patients had none of the clinical features listed in the WHO Clinical Criteria for the Diagnosis of AIDS, apart from fever, cough and weight loss. Stevens-Johnson Syndrome was reported in 7/52 (13%) patients with HIV infection, and in 4/144 (3%) patients without (RR 4.85, 95% CI: 1.45-15.88). The management of HIV-associated tuberculosis is complex and requires more resources than have previously been given to tuberculosis treatment services.
引用
收藏
页码:45 / 51
页数:7
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