title: HIV co-infection with tuberculous and non-tuberculous mycobacteria in western Kenya: challenges in the diagnosis and management.
abstract: BACKGROUND
  Tuberculosis (TB) and HIV co-infections have a global prevalence with devastating morbidity and massive mortality, Sub-Saharan Africa being the worst hit.
  
  
  OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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%.
  
  
  CONCLUSIONS
  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.
authors: Moi University School of Medicine, Kenya. henrynyamogoba@yahoo.co.uk
authors: H D N
authors: HD
authors: Nyamogoba
authors: G
authors: G
authors: Mbuthia
authors: S
authors: S
authors: Mining
authors: G
authors: G
authors: Kikuvi
authors: R
authors: R
authors: Biegon
authors: S
authors: S
authors: Mpoke
authors: D
authors: D
authors: Menya
authors: P G
authors: PG
authors: Waiyaki
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis* / Q000453:epidemiology; D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D002648:Child; D002675:Child, Preschool; D060085:Coinfection / Q000175:diagnosis / Q000453:epidemiology; D003430:Cross-Sectional Studies; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000453:epidemiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007630:Kenya / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009165:Mycobacterium Infections, Nontuberculous / Q000175:diagnosis* / Q000453:epidemiology; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification*; D009170:Nontuberculous Mycobacteria / Q000302:isolation & purification*; D015995:Prevalence; D017678:Sex Distribution; D012959:Socioeconomic Factors; D013183:Sputum / Q000382:microbiology; D011795:Surveys and Questionnaires; D014376:Tuberculosis / Q000175:diagnosis* / Q000453:epidemiology / Q000382:microbiology; D055815:Young Adult
keywords: HIV co-infection; TB diagnosis; Tuberculosis; high prevalence
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