Awadalla Heitham, El-Samani Fateh, Soghaier Mohammed A, Makki Mahgoub
Public Health Specialist, Federal Ministry of Health, Public Health Institute, Khartoum, Sudan.
Professor of Public Health, Ahfad University for Women, Omdurman, Sudan and WHO regional consultant.
AIMS Public Health. 2015 Dec 2;2(4):784-792. doi: 10.3934/publichealth.2015.4.784. eCollection 2015.
Tuberculosis (TB) screening among patients infected with Human Immunodeficiency Virus (HIV) is one of the approaches for controlling TB-HIV co-infection. The absence of typical TB symptoms among HIV-infected patients makes diagnosis challenging. Identifying predisposing risk factors of TB among HIV-infected patients could possibly guide TB diagnosis and treatment. This study was designed to identify some important factors associated with TB among HIV-infected patients and to quantify the strength of this association.
In 2010, a case control study was conducted in Khartoum State, Sudan. Cases and controls were selected by simple random sampling with a 1:2 ratio; 97 cases and 194 controls were enrolled in the study. A logistic regression model was built to estimate and quantify the strength of the association between the study variables and the outcome; a -value less than 0.05 was considered the cut-off point for a significant statistical association.
Past history of TB, CD4 count < 200 cells/µl, late clinical stages, non-employment, and no formal education were found to be risk factors for developing TB among HIV-infected patients. The adjusted ORs and 95% CIs were (6.9: 3.75-12.99), (4.8: 1.57-15.26), (5.8: 1.88-17.96), (2.5: 1.26-5.03), and (2.5: 1.28-4.63), respectively. Poor adherence, marital status, age, and gender are not associated with developing TB among HIV patients.
HIV patients who have at least one of the risk factors found in this analysis are at higher risk of TB; therefore, they should be screened more frequently and treated promptly, especially HIV patients with previous TB.
对感染人类免疫缺陷病毒(HIV)的患者进行结核病(TB)筛查是控制结核 - 艾滋病毒合并感染的方法之一。HIV感染患者缺乏典型的结核病症状使得诊断具有挑战性。识别HIV感染患者中结核病的易感风险因素可能有助于指导结核病的诊断和治疗。本研究旨在确定HIV感染患者中与结核病相关的一些重要因素,并量化这种关联的强度。
2010年,在苏丹喀土穆州进行了一项病例对照研究。通过简单随机抽样以1:2的比例选择病例和对照;97例病例和194例对照纳入研究。建立逻辑回归模型来估计和量化研究变量与结果之间关联的强度;P值小于0.05被认为是具有显著统计学关联的临界点。
发现既往结核病史、CD4细胞计数<200个/微升、临床晚期、未就业和未接受正规教育是HIV感染患者发生结核病的风险因素。调整后的比值比(OR)和95%置信区间(CI)分别为(6.9:3.75 - 12.99)、(4.8:1.57 - 15.26)、(5.8:1.88 - 17.96)、(2.5:1.26 - 5.03)和(2.5:1.28 - 4.63)。依从性差、婚姻状况、年龄和性别与HIV患者发生结核病无关。
在本分析中发现至少有一种风险因素的HIV患者患结核病的风险更高;因此,他们应更频繁地接受筛查并及时治疗,尤其是既往有结核病的HIV患者。