Verma S C, Dhungana G P, Joshi H S, Kunwar H B, Pokhrel A K
National TB Center, Bhaktapur, Nepal.
J Nepal Health Res Counc. 2012 Jan;10(1):32-6.
Tuberculosis (TB) is a major public health problem in Nepal. HIV co-infection has further added a serious challenge to control TB. An early diagnosis and treatment of TB in HIV infected individuals can help reduce not only the morbidity and mortality associated in this high risk group but also to control the TB burden in Nepal.
Clinical and bacteriological examination for pulmonary TB was carried out in 184 HIV positive persons from the community in Pokhara. Questionnaire was used to screen for symptoms and collect participants' demographic information and potential risk factors for TB.
Eighty (43.5%) sero-positive participants were young adult (21-30 years), followed by 71 (38.6%) middle aged (31-40 years) persons. Eleven participants were found to have Mycobacterium tuberculosis in their sputum, giving an overall prevalence of tuberculosis of 5.97%. All 11 cases were detected by Acid Fast Bacilli (AFB) culture, of which only three cases were detected by direct microscopy of AFB stained sputum smear. The majority of TB/HIV patients were asymptomatic with low AFB smear positivity. No significant association was found between TB and risk factors like ARV status, common clinical features of tuberculosis and smoking habit. However, significant association was found between the alcohol consumption and TB (X2=4.11, p<0.05).
High prevalence of tuberculosis (5.97%) was found among HIV infected persons. Alcohol consumption was associated with the development of tuberculosis. Majority of the studied subjects were asymptomatic for common signs and symptoms of TB. Weight loss was observed in 43% of the studied subjects followed by chest pain (39.2%), loss of appetite (34.8%), fever (34.8%) and night sweat (26.1%). Only 27% of the TB cases were found to be smear-positive.
结核病是尼泊尔的一个主要公共卫生问题。艾滋病毒合并感染给结核病控制带来了进一步的严峻挑战。对艾滋病毒感染者的结核病进行早期诊断和治疗，不仅有助于降低这一高危人群的发病率和死亡率，还能控制尼泊尔的结核病负担。
对博卡拉社区的184名艾滋病毒阳性者进行了肺结核的临床和细菌学检查。采用问卷调查来筛查症状，并收集参与者的人口统计学信息以及结核病的潜在危险因素。
80名（43.5%）血清阳性参与者为青年成年人（21 - 30岁），其次是71名（38.6%）中年（31 - 40岁）人。11名参与者的痰液中发现结核分枝杆菌，结核病总体患病率为5.97%。所有11例均通过抗酸杆菌（AFB）培养检测到，其中仅3例通过AFB染色痰液涂片直接显微镜检查检测到。大多数结核病/艾滋病毒患者无症状，AFB涂片阳性率低。未发现结核病与抗逆转录病毒治疗状态、结核病常见临床特征和吸烟习惯等危险因素之间存在显著关联。然而，发现饮酒与结核病之间存在显著关联（X2 = 4.11，p < 0.05）。
在艾滋病毒感染者中发现结核病的高患病率（5.97%）。饮酒与结核病的发生有关。大多数研究对象没有结核病的常见体征和症状。43%的研究对象出现体重减轻，其次是胸痛（39.2%）、食欲不振（34.8%）、发热（34.8%）和盗汗（26.1%）。仅27%的结核病例被发现涂片阳性。
