HIV co-infection with tuberculous and non-tuberculous mycobacteria in western Kenya: Challenges in the diagnosis and management

Institute of Tropical Medicine and Infectious Diseases, Jomo Kenyatta University of Agriculture and Technology, Kenya.
African health sciences (Impact Factor: 0.72). 09/2012; 12(3):305-11. DOI: 10.4314/ahs.v12i3.9
Source: PubMed


Tuberculosis (TB) and HIV co-infections have a global prevalence with devastating morbidity and massive mortality, Sub-Saharan Africa being the worst hit.
To evaluate the prevalence of TB-HIV co-infection and demonstrate the confusion caused by NTM and HIV/AIDS co-infection in TB diagnosis and treatment in western Kenya.
In a cross-sectional study carried out at 10 hospitals in western Kenya, sputa from consenting 872 TB suspects underwent microscopy, and culture on Lowenstein-Jensen and Mycobacteria Growth Index Tube media. Isolates were identified using the Hain's GenoType(®)Mycobacterium CM and GenoType(®)Mycobacterium AS kits. A total of 695 participants were screened for HIV using Uni-Gold™ test and positives confirmed with the enzyme linked immunosorbent assay.
A total of 346 (39.7%) participants were diagnosed with TB. Out of the 346 TB cases, 263 (76%) were tested for HIV infection and 110 (41.8%) of these were sero-positive (co-infected). The female to male TB-HIV co-infection prevalence ratio (PR) was 1.35. This study reports isolation of non-tuberculous mycobacteria from TB suspects at a rate of 1.7%.
A high TB-HIV co-infection rate was observed in this study. The NTM disease could be misdiagnosed and treated as TB in western Kenya.

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Available from: G. W. Mbuthia, Feb 05, 2016
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    • "Although not yet in common use in the region, emerging epidemiologic techniques, such as directed acyclic graph (DAG)-based causal analysis[8], have potential to improve our understanding of risk factors for mortality in this setting. DAG-based techniques are particularly appealing in sub-Saharan Africa, as mortality risk factors in individual patients rarely occur in isolation[9]. Such studies can also guide selection of interventions by determining mediators of observed mortality risk and comparing likely benefits from alternative intervention approaches[10]. "

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