title: Clinical and epidemiological profile and prevalence of tuberculosis/HIV co-infection in a regional health district in the state of Maranhão, Brazil.
abstract: OBJECTIVE
  To describe the clinical and epidemiological profile, as well as the prevalence, of tuberculosis/HIV co-infection in the Regional Health District of Tocantins, which serves 14 cities in the state of Maranhão, Brazil.
  
  
  METHODS
  This was a descriptive epidemiological study based on secondary data obtained from individual tuberculosis reporting forms in the Brazilian Case Registry Database. We included all reported cases of tuberculosis/HIV co-infection, by city, between January of 2001 and December of 2010.
  
  
  RESULTS
  In the district, 1,746 cases of tuberculosis were reported. Of those tested for HIV, 100 had positive results, which corresponded to a tuberculosis/HIV co-infection prevalence of 39%. Of the co-infected patients, 79% were male, 42% were Mulatto, and 64% were in the 20- to 40-year age bracket, 31% had had < 4 years of schooling, and 88% resided in the city of Imperatriz. Cases of pulmonary tuberculosis and new cases of tuberculosis predominated (in 87% and 73%, respectively). Of the co-infected patients, 27% had positive sputum smear microscopy results, and 89% had chest X-ray findings suggestive of tuberculosis. Sputum culture was performed in only 7% of the cases.
  
  
  CONCLUSIONS
  Our results show that, because of its clinical and epidemiological profile, tuberculosis/HIV co-infection is still a major public health problem in the southwestern region of Maranhão. This situation calls for better coordination between tuberculosis and sexually transmitted disease/AIDS control programs, as well as a political commitment and greater involvement on the part of administrators and health care professionals in the planning of interventions and the functioning of health care facilities.
authors.affiliation: Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil. marcelinosn@gmail.com
authors.forename: Marcelino
authors.initials: M
authors.lastname: Santos Neto
authors.forename: Fabiane Leita da
authors.initials: FL
authors.lastname: Silva
authors.forename: Keyla Rodrigues de
authors.initials: KR
authors.lastname: Sousa
authors.forename: Mellina
authors.initials: M
authors.lastname: Yamamura
authors.forename: Marcela Paschoal
authors.initials: MP
authors.lastname: Popolin
authors.forename: Ricardo Alexandre
authors.initials: RA
authors.lastname: Arcêncio
mesh_terms: D000328:Adult; D001938:Brazil / Q000453:epidemiology; D060085:Coinfection / Q000453:epidemiology*; D005260:Female; D015658:HIV Infections / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012959:Socioeconomic Factors; D014376:Tuberculosis / Q000453:epidemiology*; D055815:Young Adult