title: TB-HIV co-infection in the Netherlands: estimating prevalence and under-reporting in national registration databases using a capture-recapture analysis.
abstract: Knowledge of the HIV status in patients with tuberculosis (TB) and vice versa is crucial for proper individual patient management, while knowledge of the prevalence of co-infection guides preventive and therapeutic strategies. The aim of the study was to assess if national disease databases on TB and HIV are adequate sources to provide this information.
  
  
  
  A two way capture-recapture analysis to assess the completeness of the registers, and to obtain the prevalence of TB-HIV co-infection in the Netherlands in the years 2002-2012.
  
  
  
  HIV testing was performed in less than 50% of the patients with TB. Of the 932 TB-HIV infected patients, just 293 (31.4%) were registered in both registers. Under-reporting of TB-HIV co-infection ranged from 50% to 70% in the national TB register, and from 31% to 37% in the HIV database. Prevalence of TB-HIV co-infection in the Netherlands in 2012 was 7.1% (95% CI 6.0% to 8.3%), which was more than double of the prevalence estimated from the national TB database.
  
  
  
  TB-HIV co-infection is markedly under-reported in national disease databases. There is an urgent need for improved registration and preferably a routine data exchange between the two surveillance systems.
authors.affiliation: Department of Global Health, Academic Medical Center, University of Amsterdam, Amsterdam Institute for Global Health and Development, Amsterdam, The Netherlands.
authors.forename: Frank
authors.initials: F
authors.lastname: van Leth
authors.affiliation: Amsterdam Institute for Global Health and Development, Amsterdam, The Netherlands.
authors.forename: Kirsten
authors.initials: K
authors.lastname: Evenblij
authors.affiliation: Department of Global Health, Academic Medical Center, University of Amsterdam, Amsterdam Institute for Global Health and Development, Amsterdam, The Netherlands Department of Internal Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Ferdinand
authors.initials: F
authors.lastname: Wit
authors.affiliation: Municipal Public Health Service Fryslân, Leeuwarden, The Netherlands.
authors.forename: Albert
authors.initials: A
authors.lastname: Kiers
authors.affiliation: Department of Internal Medicine, Infectious Diseases Service, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
authors.forename: Herman
authors.initials: H
authors.lastname: Sprenger
authors.affiliation: Municipal Public Health Service Limburg-Noord, Venlo, The Netherlands.
authors.forename: Maurits
authors.initials: M
authors.lastname: Verhagen
authors.affiliation: Stichting HIV Monitoring, Amsterdam, The Netherlands.
authors.forename: Mariska
authors.initials: M
authors.lastname: Hillebregt
authors.affiliation: KNCV Tuberculosis Foundation, The Hague, The Netherlands.
authors.forename: Nico
authors.initials: N
authors.lastname: Kalisvaart
authors.affiliation: National Institute for Public Health and Environment, Bilthoven, The Netherlands.
authors.forename: Henrieke
authors.initials: H
authors.lastname: Schimmel
authors.affiliation: Department of Internal Medicine, Division of Infectious Diseases, Erasmus Medical Center, Rotterdam, The Netherlands.
authors.forename: Annelies
authors.initials: A
authors.lastname: Verbon
mesh_terms: D000293:Adolescent; D000328:Adult; D060085:Coinfection / Q000453:epidemiology*; D018563:Disease Notification / Q000592:standards / Q000706:statistics & numerical data*; D005260:Female; D015658:HIV Infections / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D011159:Population Surveillance; D015995:Prevalence; D040442:Public Health Informatics / Q000592:standards / Q000706:statistics & numerical data*; D012042:Registries; D014376:Tuberculosis / Q000453:epidemiology*
keywords: PUBLIC HEALTH; SURVEILLANCE; TUBERCULOSIS