SETTING: Banteay Meanchey Province, Cambodia. OBJECTIVE: The World Health Organization recommends human immunodeficiency virus (HIV) testing for all tuberculosis (TB) patients and TB screening for all HIV-infected persons in countries with a TB-HIV syndemic. We sought to determine whether evidence supports implementing these recommendations in South-East Asia. DESIGN: We conducted a cross-sectional survey and retrospective cohort study of patients newly diagnosed with HIV or TB from October 2003 to February 2005 to identify risk factors for HIV infection and TB, and for death during TB treatment. RESULTS: HIV infection was diagnosed in 216/574 (38%) TB patients. TB disease was found in 124/450 (24%) HIV-infected persons. No sub-groups of patients had a low risk of HIV infection or TB. Of 180 TB patients with HIV infection and a recorded treatment outcome, 49 (27%) died compared to 17/357 (5%) without HIV infection (relative risk [RR] 5.2, 95% confidence interval [CI] 3.1-8.7). HIV-infected TB patients with smear-negative pulmonary disease died less frequently than those with smear-positive pulmonary disease (RR 0.39, 95%CI 0.16-0.93). CONCLUSIONS: No sub-groups of patients had low risk for HIV infection or TB, and mortality among HIV-infected TB patients was high. These data justify using the WHO global TB-HIV recommendations in South-East Asia. Urgent interventions are needed to reduce the high mortality rate in HIV-infected TB patients.
SETTING: Banteay Meanchey Province, Cambodia. OBJECTIVE: The World Health Organization recommends human immunodeficiency virus (HIV) testing for all tuberculosis (TB) patients and TB screening for all HIV-infectedpersons in countries with a TB-HIV syndemic. We sought to determine whether evidence supports implementing these recommendations in South-East Asia. DESIGN: We conducted a cross-sectional survey and retrospective cohort study of patients newly diagnosed with HIV or TB from October 2003 to February 2005 to identify risk factors for HIV infection and TB, and for death during TB treatment. RESULTS:HIV infection was diagnosed in 216/574 (38%) TB patients. TB disease was found in 124/450 (24%) HIV-infectedpersons. No sub-groups of patients had a low risk of HIV infection or TB. Of 180 TB patients with HIV infection and a recorded treatment outcome, 49 (27%) died compared to 17/357 (5%) without HIV infection (relative risk [RR] 5.2, 95% confidence interval [CI] 3.1-8.7). HIV-infected TBpatients with smear-negative pulmonary disease died less frequently than those with smear-positive pulmonary disease (RR 0.39, 95%CI 0.16-0.93). CONCLUSIONS: No sub-groups of patients had low risk for HIV infection or TB, and mortality among HIV-infected TBpatients was high. These data justify using the WHO global TB-HIV recommendations in South-East Asia. Urgent interventions are needed to reduce the high mortality rate in HIV-infected TBpatients.
Authors: G E Oramasionwu; C M Heilig; N Udomsantisuk; M E Kimerling; B Eng; H D Nguyen; S Thai; C Keo; K D McCarthy; J K Varma; K P Cain Journal: Int J Tuberc Lung Dis Date: 2013-08 Impact factor: 2.373
Authors: Olivier Koole; Sopheak Thai; Kim Eam Khun; Reaksmey Pe; Johan van Griensven; Ludwig Apers; Jef Van den Ende; Tan Eang Mao; Lutgarde Lynen Journal: PLoS One Date: 2011-04-06 Impact factor: 3.240
Authors: Eric S Pevzner; Greet Vandebriel; David W Lowrance; Michel Gasana; Alyssa Finlay Journal: BMC Public Health Date: 2011-07-11 Impact factor: 3.295
Authors: Ferdinand M Mugusi; Saurabh Mehta; Eduardo Villamor; Willy Urassa; Elmar Saathoff; Ronald J Bosch; Wafaie W Fawzi Journal: BMC Public Health Date: 2009-11-12 Impact factor: 3.295
Authors: Evans Sagwa; Aukje Kaija Mantel-Teeuwisse; Nunurai Ruswa; Jean Paul Musasa; Shanthi Pal; Panganai Dhliwayo; Brian van Wyk Journal: South Med Rev Date: 2012-07-23
Authors: Jay K Varma; Sriprapa Nateniyom; Somsak Akksilp; Wiroj Mankatittham; Chawin Sirinak; Wanchai Sattayawuthipong; Channawong Burapat; Wanitchaya Kittikraisak; Patama Monkongdee; Kevin P Cain; Charles D Wells; Jordan W Tappero Journal: BMC Infect Dis Date: 2009-04-13 Impact factor: 3.090