International Journal of Medical and Health Research

Authors
Dr. Ahsan Hamidi, Dr. Shamim Ahmad, Dr. SN Singh

Abstract
Introduction: TB-HIV co-infection is one of the biggest public health challenges in India. Although there is a wealth of information on TB-HIV co-infection among settled populations and elsewhere, to our knowledge, there are no published reports on TB-HIV co-infection from pastoral communities. In this study, we report the prevalence of TB, HIV and TB-HIV co-infection among pulmonary TB suspects. Design: In a cross-sectional study design, 325 pulmonary TB suspects were included from five health facilities. Three sputum samples (spot-morning-spot) were collected from each participant. Sputum samples were examined for the presence of acid fast bacilli using ZiehlNeelsen staining method, and culture was done on the remaining sputum samples. Participants were interviewed and HIV tested. Results: Of the 325 pulmonary TB suspects, 44 (13.5%) were smear positive, and 105 (32.3%) were culture positive. Among smear-positive patients, five were culture negative and, therefore, a total of 110 (33.8%) suspects were bacteriologically confirmed pulmonary TB patients. Out of 287 pulmonary TB suspects who were tested for HIV infection, 82 (28.6%) were HIV positive. A significantly higher proportion of bacteriologically confirmed pulmonary TB patients [40 (40.4%)] were HIV co-infected compared with patients without bacteriological evidence for pulmonary TB [42 (22.3%)]. However, HIV infections in smear- and/or culture-negative pulmonary TB suspects [7 (7.6%)] and bacteriologically confirmed pulmonary TB patients [4 (11.8%)] were comparable. On multivariable logistic regression analysis, ethnicity was independently associated with low HIV infection [OR0.16 (95% CI: 0.070.37)], whereas literacy was independently associated with higher HIV infection [OR2.21 (95% CI: 1.054.64)]. Conclusions: Although the overall prevalence of TB-HIV co-infection in the current study is high, ethnic had significantly lower HIV infection both in suspects as well as TB patients. The data suggest that the prevalence of HIV infection among pastoralists is probably low. However, population-based prevalence studies are needed to substantiate our findings.