HIV sero-prevalence among tuberculosis patients in Kenya.
OBJECTIVE
To determine HIV seroprevalence among tuberculosis patients and the burden of HIV attributable tuberculosis among notified patients in Kenya.


METHODS
A cross-sectional anonymous unlinked HIV seroprevalence survey.


METHODS
Tuberculosis diagnostic clinics of the National Leprosy Tuberculosis Programme in 19 districts.


METHODS
One thousand nine hundred and fifty-two newly notified tuberculosis patients.


METHODS
Selection and registration of eligible subjects followed by obtaining 5 ml of full blood for haemoglobin testing and separation of serum for HIV testing by ELISA.


METHODS
HIV seroprevalence per district and burden of HIV attributable tuberculosis among tuberculosis patients.


RESULTS
A total of 1,952 eligible patients were enrolled. The weighted seroprevalence in the sample was 40.7% (range 11.8-79.6% per district). The seroprevalence was significantly higher among females and patients with sputum-smear negative tuberculosis. Chronic diarrhoea, female sex, oral thrush and a negative sputum were independent risk factors for HIV infection. The Odds ratio for HIV infection in female tuberculosis patients aged 15-44 years, was 5.6 (95% CI 4.5-6.9) compared with ante-natal clinic attenders. The population attributable risk was 0.22 in 1994.


CONCLUSIONS
The HIV epidemic has had a profound impact on the tuberculosis epidemic in Kenya and explains about 41% of the 94.5% increase of registered patients in the period 1990-1994 and 20% of all registered patients in 1994. Repetition of the survey with inclusion of a more representative control group from the general population may provide a more accurate estimation of the burden of HIV attributable tuberculosis.
Van Gorkom
J
J
Royal Netherlands Tuberculosis Association, The Hague, Netherlands.
Kibuga
D
D
Adallah
S
S
Adungosi
J
J
Aluvaala
B
B
Kangangi
J
J
Kutwa
A
A
Olewe
M
M
Rono
P
P
Wambua
M
M
D017088:AIDS-Related Opportunistic Infections / Q000453:epidemiology*; D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D015528:HIV Seroprevalence; D006801:Humans; D007630:Kenya / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D012307:Risk Factors; D017678:Sex Distribution; D014376:Tuberculosis / Q000453:epidemiology*