title: Tuberculosis and HIV at the national level in Kenya: results from the Second Kenya AIDS Indicator Survey.
abstract: BACKGROUND
  Co-morbidity with tuberculosis and HIV is a common cause of mortality in sub-Saharan Africa. In the second Kenya AIDS Indicator Survey, we collected data on knowledge and experience of HIV and tuberculosis, as well as on access to and coverage of relevant treatment services and antiretroviral therapy (ART) in Kenya.
  
  
  METHODS
  A national, population-based household survey was conducted from October 2012 to February 2013. Information was collected through household questionnaires, and blood samples were taken for HIV, CD4 cell counts, and HIV viral load testing at a central laboratory.
  
  
  RESULTS
  Overall, 13,720 persons aged 15-64 years participated; 96.7% [95% confidence interval (CI): 96.3 to 97.1] had heard of tuberculosis, of whom 2.0% (95% CI: 1.7 to 2.2) reported having prior tuberculosis. Among those with laboratory-confirmed HIV infection, 11.6% (95% CI: 8.9 to 14.3) reported prior tuberculosis. The prevalence of laboratory-confirmed HIV infection in persons reporting prior tuberculosis was 33.2% (95% CI: 26.2 to 40.2) compared to 5.1% (95% CI: 4.5 to 5.8) in persons without prior tuberculosis. Among those in care, coverage of ART for treatment-eligible persons was 100% for those with prior tuberculosis and 88.6% (95% CI: 81.6 to 95.7) for those without. Among all HIV-infected persons, ART coverage among treatment-eligible persons was 86.9% (95% CI: 74.2 to 99.5) for persons with prior tuberculosis and 58.3% (95% CI: 47.6 to 69.0) for those without.
  
  
  CONCLUSIONS
  Morbidity from tuberculosis and HIV remain major health challenges in Kenya. Tuberculosis is an important entry point for HIV diagnosis and treatment. Lack of knowledge of HIV serostatus is an obstacle to access to HIV services and timely ART for prevention of HIV transmission and HIV-associated disease, including tuberculosis.
authors.affiliation: *National AIDS and Sexually Transmitted Infection (STI) Control Programme, Ministry of Health, Nairobi, Kenya; †Divison of Global HIV/AIDS, Center for Global health, US Centers for Disease Control and Prevention, Nairobi, Kenya; and ‡Global Health Sciences, University of California, San Francisco, San Francisco, CA.
authors.forename: Agneta
authors.initials: A
authors.lastname: Mbithi
authors.forename: Anthony
authors.initials: A
authors.lastname: Gichangi
authors.forename: Andrea A
authors.initials: AA
authors.lastname: Kim
authors.forename: Abraham
authors.initials: A
authors.lastname: Katana
authors.forename: Herman
authors.initials: H
authors.lastname: Weyenga
authors.forename: John
authors.initials: J
authors.lastname: Williamson
authors.forename: Katherine
authors.initials: K
authors.lastname: Robinson
authors.forename: Tom
authors.initials: T
authors.lastname: Oluoch
authors.forename: William K
authors.initials: WK
authors.lastname: Maina
authors.forename: Timothy A
authors.initials: TA
authors.lastname: Kellogg
authors.forename: Kevin M
authors.initials: KM
authors.lastname: De Cock
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D015897:Comorbidity; D003430:Cross-Sectional Studies; D004522:Educational Status; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000453:epidemiology*; D007722:Health Knowledge, Attitudes, Practice; D006306:Health Surveys; D006801:Humans; D007630:Kenya / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D015995:Prevalence; D012424:Rural Population / Q000706:statistics & numerical data; D012737:Sex Factors; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy / Q000453:epidemiology*; D014505:Urban Population / Q000706:statistics & numerical data; D055815:Young Adult
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