1Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan.
2Department of Community Medicine, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe.
Am J Trop Med Hyg. 2020 Jul;103(1):214-220. doi: 10.4269/ajtmh.19-0856. Epub 2020 May 14.
Country-specific interventions targeting high-risk groups are necessary for a global reduction in Tuberculosis (TB)/HIV burden. We analyzed the data of 13,802 TB cases diagnosed in Harare, Zimbabwe, during 2013-2017. Pearson's chi-square tests and multivariate logistic regression models were used to identify patient characteristics significantly associated with TB/HIV coinfection. Of the 13,802 TB cases analyzed, 9,725 (70.5%) were HIV positive. A significantly higher odds of having TB/HIV coinfection diagnosis was found among females, patients aged 25-64 years, previously treated cases, and acid-fast bacillus sputum smear-negative cases. Compared with nondisseminated pulmonary TB, miliary TB (adjusted odds ratio [aOR]: 1.469, 95% CI: 1.071, 2.015) and TB meningitis (aOR: 1.715, 95% CI: 1.074, 2.736) both had a significantly higher odds for TB/HIV coinfection, whereas pleural TB (aOR 0.420, 95% CI: 0.354, 0.497) and all other extrapulmonary TB (EPTB) (aOR: 0.606, 95% CI: 0.516 0.712) were significantly less likely to have TB/HIV coinfection. The risk for TB/HIV coinfection varied significantly by patients' sociodemographic and clinical characteristics in Harare. Our finding that different forms of EPTB have different relationships with HIV coinfection has extended the knowledge base about clinical markers for TB/HIV coinfection which can lead to a greater public health impact on eliminating TB/HIV infection.
针对高危人群的特定国家干预措施对于减少全球结核病（TB）/艾滋病毒负担是必要的。我们分析了 2013-2017 年在津巴布韦哈拉雷诊断的 13802 例结核病病例的数据。使用 Pearson 卡方检验和多变量逻辑回归模型来确定与 TB/HIV 合并感染显著相关的患者特征。在分析的 13802 例结核病病例中，9725 例（70.5%）HIV 阳性。女性、25-64 岁的患者、既往治疗病例和抗酸杆菌痰涂片阴性病例发生 TB/HIV 合并感染诊断的可能性显著更高。与非播散性肺结核相比，粟粒性肺结核（调整后的优势比[aOR]：1.469，95%可信区间[CI]：1.071，2.015）和结核性脑膜炎（aOR：1.715，95% CI：1.074，2.736）合并感染 TB/HIV 的可能性显著更高，而胸腔内 TB（aOR 0.420，95% CI：0.354，0.497）和所有其他肺外 TB（EPTB）（aOR：0.606，95% CI：0.516，0.712）发生 TB/HIV 合并感染的可能性显著降低。哈拉雷的患者社会人口统计学和临床特征的不同显著影响了 TB/HIV 合并感染的风险。我们发现不同形式的 EPTB 与 HIV 合并感染的关系不同，这扩展了关于 TB/HIV 合并感染的临床标志物的知识库，这可以对消除 TB/HIV 感染产生更大的公共卫生影响。
