Surveillance of tuberculosis among HIV infected persons in three different regions of Nepal

Tuberculosis itself is a major public health problem in Nepal. The emergence of HIV has caused sharp increase in TB incidence in the community. Surveillance of TB/HIV co-infection helps in developing effective TB/HIV control strategies. The objective of this study was to measure prevalence of TB among HIV/AIDS patients in the selected regions. Between December 2006 and May 2008, a cross-sectional study was conducted in three different settings namely Tribhuvan University Teaching hospital, Kathmandu; Regional Tuberculosis Centre, Pokhara and Shree Siddhanath Science Campus, Mahendranagar. After taking informed consent pre-structured questionnaire was administered. Sputum specimen was collected from HIV/AIDS patients to investigate tuberculosis by culture and microscopy. Data analysis was done using SPSS 11.5. Of the 394 HIV infected persons, 225 (57.1%) were male and 169 (42.9%) female. The overall prevalence of TB was found to be 8.1%. Clinical signs and symptoms were significantly lower in those patients undergoing ART (chi2 value ranging from 4.19 to 9.13). However, development of tuberculosis is independent of ART status (chi2 value 1.14) and CD4 level (chi2 value 3.25). TB case detection rate by cultural technique was found to be twice as superior as direct microscopy. It can be concluded that smear negative TB constitute the significant proportion of TB cases in HIV infected persons.