Proportion and determinants of tuberculosis among human immunodeficiency virus-positive patients attending the antiretroviral therapy center attached to a Medical College in South India
Identifieur interne : 000528 ( Pmc/Checkpoint ); précédent : 000527; suivant : 000529Proportion and determinants of tuberculosis among human immunodeficiency virus-positive patients attending the antiretroviral therapy center attached to a Medical College in South India
Auteurs : Vandana Hiregoudar ; Bellara Raghavendra ; Aravind Karinagannavar ; Wahid Khan ; Sneha Kamble ; Timmalapur G. GoudSource :
- Journal of Family & Community Medicine [ 1319-1683 ] ; 2016.
Abstract
The human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) pandemic has caused a re-emergence of tuberculosis (TB). In persons infected with both HIV and TB, the lifetime risk of developing TB disease is 50–70% compared to 10% in HIV-negative individuals. India has world's 3rd highest HIV burden and is also one of the countries endemic for TB, so the country faces a dual epidemic of HIV and TB.
To find out the proportion and determinants of TB in HIV-positive subjects.
This study was undertaken at the ART center from June 01, 2012, to May 31, 2013. HIV-positive subjects aged above 15 years who had been on antiretroviral therapy (ART) for more than 6 months were included in the study. Nonprobability purposive sampling was adopted. A predesigned semi-structured questionnaire was used to obtain data.
A total of 536 HIV-positive people were interviewed, 58.8% of whom were males, 79.1% were Hindu, 61.0% had up to high school education, and 57% were unskilled laborers. About 63% were married, 40% were from the upper lower class, and 60% were from urban areas. For the majority (89.1%), the probable mode of transmission of HIV was by the heterosexual route. TB co-infection was present in 38.4% subjects. The most common form of TB was extra-pulmonary in subjects on antituberculous treatment (47.3%) and among old cases (57.6%). On bivariate analysis, 136 (42.4%) married subjects and those from rural areas were more commonly affected by TB compared to subjects who were unmarried and from urban areas with odds ratio (OR): 1.555, confidence interval (CI): 1.077–2.246 and OR: 1.523, CI: 1.061–2.185, respectively. The proportion of TB was high among subjects who lived in overcrowded houses 130 (44.2%), and who had a habit of alcohol use compared to others with OR: 1.731, CI: 1.734–2.179 and OR: 1.524, CI: 1.045–2.223, respectively. Logistic regression analysis showed that TB among people living with HIV/AIDS was highest in persons living in overcrowded houses (OR: 1.706, CI: 1.185–2.458) and those who consumed alcohol (OR: 1.605, CI: 1.090–2.362).
Demographic factors like male gender, middle age, living in the rural areas, consumption of alcohol, and living in overcrowded houses were found with a higher proportion of TB. The use of highly active ART appeared to progressively decrease but did not completely eliminate the risk of TB.
Url:
DOI: 10.4103/2230-8229.181009
PubMed: 27186154
PubMed Central: 4859104
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Proportion and determinants of tuberculosis among human immunodeficiency virus-positive patients attending the antiretroviral therapy center attached to a Medical College in South India</title><author><name sortKey="Hiregoudar, Vandana" sort="Hiregoudar, Vandana" uniqKey="Hiregoudar V" first="Vandana" last="Hiregoudar">Vandana Hiregoudar</name><affiliation><nlm:aff id="aff1"></nlm:aff></affiliation></author><author><name sortKey="Raghavendra, Bellara" sort="Raghavendra, Bellara" uniqKey="Raghavendra B" first="Bellara" last="Raghavendra">Bellara Raghavendra</name><affiliation><nlm:aff id="aff2"><italic>Department of Community Medicine, VIMS, Bellary, Karnataka, India</italic></nlm:aff></affiliation></author><author><name sortKey="Karinagannavar, Aravind" sort="Karinagannavar, Aravind" uniqKey="Karinagannavar A" first="Aravind" last="Karinagannavar">Aravind Karinagannavar</name><affiliation><nlm:aff id="aff3"><italic>Department of Community Medicine, MIMS, Mysore, Karnataka, India</italic></nlm:aff></affiliation></author><author><name sortKey="Khan, Wahid" sort="Khan, Wahid" uniqKey="Khan W" first="Wahid" last="Khan">Wahid Khan</name><affiliation><nlm:aff id="aff2"><italic>Department of Community Medicine, VIMS, Bellary, Karnataka, India</italic></nlm:aff></affiliation></author><author><name sortKey="Kamble, Sneha" sort="Kamble, Sneha" uniqKey="Kamble S" first="Sneha" last="Kamble">Sneha Kamble</name><affiliation><nlm:aff id="aff2"><italic>Department of Community Medicine, VIMS, Bellary, Karnataka, India</italic></nlm:aff></affiliation></author><author><name sortKey="Goud, Timmalapur G" sort="Goud, Timmalapur G" uniqKey="Goud T" first="Timmalapur G." last="Goud">Timmalapur G. Goud</name><affiliation><nlm:aff id="aff2"><italic>Department of Community Medicine, VIMS, Bellary, Karnataka, India</italic></nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">27186154</idno><idno type="pmc">4859104</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4859104</idno><idno type="RBID">PMC:4859104</idno><idno type="doi">10.4103/2230-8229.181009</idno><date when="2016">2016</date><idno type="wicri:Area/Pmc/Corpus">000382</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000382</idno><idno type="wicri:Area/Pmc/Curation">000382</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000382</idno><idno type="wicri:Area/Pmc/Checkpoint">000528</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">000528</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Proportion and determinants of tuberculosis among human immunodeficiency virus-positive patients attending the antiretroviral therapy center attached to a Medical College in South India</title><author><name sortKey="Hiregoudar, Vandana" sort="Hiregoudar, Vandana" uniqKey="Hiregoudar V" first="Vandana" last="Hiregoudar">Vandana Hiregoudar</name><affiliation><nlm:aff id="aff1"></nlm:aff></affiliation></author><author><name sortKey="Raghavendra, Bellara" sort="Raghavendra, Bellara" uniqKey="Raghavendra B" first="Bellara" last="Raghavendra">Bellara Raghavendra</name><affiliation><nlm:aff id="aff2"><italic>Department of Community Medicine, VIMS, Bellary, Karnataka, India</italic></nlm:aff></affiliation></author><author><name sortKey="Karinagannavar, Aravind" sort="Karinagannavar, Aravind" uniqKey="Karinagannavar A" first="Aravind" last="Karinagannavar">Aravind Karinagannavar</name><affiliation><nlm:aff id="aff3"><italic>Department of Community Medicine, MIMS, Mysore, Karnataka, India</italic></nlm:aff></affiliation></author><author><name sortKey="Khan, Wahid" sort="Khan, Wahid" uniqKey="Khan W" first="Wahid" last="Khan">Wahid Khan</name><affiliation><nlm:aff id="aff2"><italic>Department of Community Medicine, VIMS, Bellary, Karnataka, India</italic></nlm:aff></affiliation></author><author><name sortKey="Kamble, Sneha" sort="Kamble, Sneha" uniqKey="Kamble S" first="Sneha" last="Kamble">Sneha Kamble</name><affiliation><nlm:aff id="aff2"><italic>Department of Community Medicine, VIMS, Bellary, Karnataka, India</italic></nlm:aff></affiliation></author><author><name sortKey="Goud, Timmalapur G" sort="Goud, Timmalapur G" uniqKey="Goud T" first="Timmalapur G." last="Goud">Timmalapur G. Goud</name><affiliation><nlm:aff id="aff2"><italic>Department of Community Medicine, VIMS, Bellary, Karnataka, India</italic></nlm:aff></affiliation></author></analytic><series><title level="j">Journal of Family & Community Medicine</title><idno type="ISSN">1319-1683</idno><idno type="eISSN">2229-340X</idno><imprint><date when="2016">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="st1"><title>Background:</title><p>The human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) pandemic has caused a re-emergence of tuberculosis (TB). In persons infected with both HIV and TB, the lifetime risk of developing TB disease is 50–70% compared to 10% in HIV-negative individuals. India has world's 3<sup>rd</sup> highest HIV burden and is also one of the countries endemic for TB, so the country faces a dual epidemic of HIV and TB.</p></sec><sec id="st2"><title>Objectives:</title><p>To find out the proportion and determinants of TB in HIV-positive subjects.</p></sec><sec id="st3"><title>Subjects and Methods:</title><p>This study was undertaken at the ART center from June 01, 2012, to May 31, 2013. HIV-positive subjects aged above 15 years who had been on antiretroviral therapy (ART) for more than 6 months were included in the study. Nonprobability purposive sampling was adopted. A predesigned semi-structured questionnaire was used to obtain data.</p></sec><sec id="st4"><title>Results:</title><p>A total of 536 HIV-positive people were interviewed, 58.8% of whom were males, 79.1% were Hindu, 61.0% had up to high school education, and 57% were unskilled laborers. About 63% were married, 40% were from the upper lower class, and 60% were from urban areas. For the majority (89.1%), the probable mode of transmission of HIV was by the heterosexual route. TB co-infection was present in 38.4% subjects. The most common form of TB was extra-pulmonary in subjects on antituberculous treatment (47.3%) and among old cases (57.6%). On bivariate analysis, 136 (42.4%) married subjects and those from rural areas were more commonly affected by TB compared to subjects who were unmarried and from urban areas with odds ratio (OR): 1.555, confidence interval (CI): 1.077–2.246 and OR: 1.523, CI: 1.061–2.185, respectively. The proportion of TB was high among subjects who lived in overcrowded houses 130 (44.2%), and who had a habit of alcohol use compared to others with OR: 1.731, CI: 1.734–2.179 and OR: 1.524, CI: 1.045–2.223, respectively. Logistic regression analysis showed that TB among people living with HIV/AIDS was highest in persons living in overcrowded houses (OR: 1.706, CI: 1.185–2.458) and those who consumed alcohol (OR: 1.605, CI: 1.090–2.362).</p></sec><sec id="st5"><title>Conclusions:</title><p>Demographic factors like male gender, middle age, living in the rural areas, consumption of alcohol, and living in overcrowded houses were found with a higher proportion of TB. 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<front><journal-meta><journal-id journal-id-type="nlm-ta">J Family Community Med</journal-id><journal-id journal-id-type="iso-abbrev">J Family Community Med</journal-id><journal-id journal-id-type="publisher-id">JFCM</journal-id><journal-title-group><journal-title>Journal of Family & Community Medicine</journal-title></journal-title-group><issn pub-type="ppub">1319-1683</issn><issn pub-type="epub">2229-340X</issn><publisher><publisher-name>Medknow Publications & Media Pvt Ltd</publisher-name><publisher-loc>India</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">27186154</article-id><article-id pub-id-type="pmc">4859104</article-id><article-id pub-id-type="publisher-id">JFCM-23-88</article-id><article-id pub-id-type="doi">10.4103/2230-8229.181009</article-id><article-categories><subj-group subj-group-type="heading"><subject>Original Article</subject></subj-group></article-categories><title-group><article-title>Proportion and determinants of tuberculosis among human immunodeficiency virus-positive patients attending the antiretroviral therapy center attached to a Medical College in South India</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Hiregoudar</surname><given-names>Vandana</given-names></name><xref ref-type="aff" rid="aff1"></xref><xref ref-type="corresp" rid="cor1"></xref></contrib><contrib contrib-type="author"><name><surname>Raghavendra</surname><given-names>Bellara</given-names></name><xref ref-type="aff" rid="aff2">1</xref></contrib><contrib contrib-type="author"><name><surname>Karinagannavar</surname><given-names>Aravind</given-names></name><xref ref-type="aff" rid="aff3">2</xref></contrib><contrib contrib-type="author"><name><surname>Khan</surname><given-names>Wahid</given-names></name><xref ref-type="aff" rid="aff2">1</xref></contrib><contrib contrib-type="author"><name><surname>Kamble</surname><given-names>Sneha</given-names></name><xref ref-type="aff" rid="aff2">1</xref></contrib><contrib contrib-type="author"><name><surname>Goud</surname><given-names>Timmalapur G.</given-names></name><xref ref-type="aff" rid="aff2">1</xref></contrib></contrib-group><aff id="aff1"><italic>Department of Community Medicine, SDMCMS and Hospital, Sattur, Dharwad, Karnataka, India</italic></aff><aff id="aff2"><label>1</label><italic>Department of Community Medicine, VIMS, Bellary, Karnataka, India</italic></aff><aff id="aff3"><label>2</label><italic>Department of Community Medicine, MIMS, Mysore, Karnataka, India</italic></aff><author-notes><corresp id="cor1"><bold>Address for correspondence:</bold> Dr. Vandana Hiregoudar, Department of Community Medicine, SDMCMS and Hospital, Manjushree Nagar, Sattur, Dharwad - 580 009, Karnataka, India. E-mail: <email xlink:href="vandanahiregoudar@gmail.com">vandanahiregoudar@gmail.com</email></corresp></author-notes><pub-date pub-type="ppub"><season>May-Aug</season><year>2016</year></pub-date><volume>23</volume><issue>2</issue><fpage>88</fpage><lpage>93</lpage><permissions><copyright-statement>Copyright: © Journal of Family and Community Medicine</copyright-statement><copyright-year>2016</copyright-year><license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by-nc-sa/3.0"><license-p>This is an open access article distributed under the terms of the Creative Commons Attribution NonCommercial ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non commercially, as long as the author is credited and the new creations are licensed under the identical terms.</license-p></license></permissions><abstract><sec id="st1"><title>Background:</title><p>The human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) pandemic has caused a re-emergence of tuberculosis (TB). In persons infected with both HIV and TB, the lifetime risk of developing TB disease is 50–70% compared to 10% in HIV-negative individuals. India has world's 3<sup>rd</sup> highest HIV burden and is also one of the countries endemic for TB, so the country faces a dual epidemic of HIV and TB.</p></sec><sec id="st2"><title>Objectives:</title><p>To find out the proportion and determinants of TB in HIV-positive subjects.</p></sec><sec id="st3"><title>Subjects and Methods:</title><p>This study was undertaken at the ART center from June 01, 2012, to May 31, 2013. HIV-positive subjects aged above 15 years who had been on antiretroviral therapy (ART) for more than 6 months were included in the study. Nonprobability purposive sampling was adopted. A predesigned semi-structured questionnaire was used to obtain data.</p></sec><sec id="st4"><title>Results:</title><p>A total of 536 HIV-positive people were interviewed, 58.8% of whom were males, 79.1% were Hindu, 61.0% had up to high school education, and 57% were unskilled laborers. About 63% were married, 40% were from the upper lower class, and 60% were from urban areas. For the majority (89.1%), the probable mode of transmission of HIV was by the heterosexual route. TB co-infection was present in 38.4% subjects. The most common form of TB was extra-pulmonary in subjects on antituberculous treatment (47.3%) and among old cases (57.6%). On bivariate analysis, 136 (42.4%) married subjects and those from rural areas were more commonly affected by TB compared to subjects who were unmarried and from urban areas with odds ratio (OR): 1.555, confidence interval (CI): 1.077–2.246 and OR: 1.523, CI: 1.061–2.185, respectively. The proportion of TB was high among subjects who lived in overcrowded houses 130 (44.2%), and who had a habit of alcohol use compared to others with OR: 1.731, CI: 1.734–2.179 and OR: 1.524, CI: 1.045–2.223, respectively. Logistic regression analysis showed that TB among people living with HIV/AIDS was highest in persons living in overcrowded houses (OR: 1.706, CI: 1.185–2.458) and those who consumed alcohol (OR: 1.605, CI: 1.090–2.362).</p></sec><sec id="st5"><title>Conclusions:</title><p>Demographic factors like male gender, middle age, living in the rural areas, consumption of alcohol, and living in overcrowded houses were found with a higher proportion of TB. The use of highly active ART appeared to progressively decrease but did not completely eliminate the risk of TB.</p></sec></abstract><kwd-group><kwd>Antiretroviral therapy</kwd><kwd>co-infection</kwd><kwd>human immunodeficiency virus</kwd><kwd>tuberculosis</kwd></kwd-group></article-meta></front></pmc><affiliations><list></list><tree><noCountry><name sortKey="Goud, Timmalapur G" sort="Goud, Timmalapur G" uniqKey="Goud T" first="Timmalapur G." last="Goud">Timmalapur G. Goud</name><name sortKey="Hiregoudar, Vandana" sort="Hiregoudar, Vandana" uniqKey="Hiregoudar V" first="Vandana" last="Hiregoudar">Vandana Hiregoudar</name><name sortKey="Kamble, Sneha" sort="Kamble, Sneha" uniqKey="Kamble S" first="Sneha" last="Kamble">Sneha Kamble</name><name sortKey="Karinagannavar, Aravind" sort="Karinagannavar, Aravind" uniqKey="Karinagannavar A" first="Aravind" last="Karinagannavar">Aravind Karinagannavar</name><name sortKey="Khan, Wahid" sort="Khan, Wahid" uniqKey="Khan W" first="Wahid" last="Khan">Wahid Khan</name><name sortKey="Raghavendra, Bellara" sort="Raghavendra, Bellara" uniqKey="Raghavendra B" first="Bellara" last="Raghavendra">Bellara Raghavendra</name></noCountry></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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