Abstract
OBJECTIVES: The purpose of this study was to assess the impact of the increased incidence of tuberculosis (TB) due to HIV infection on the risk of TB infection in schoolchildren. METHODS: Tuberculin surveys were carried out in randomly selected primary schools in 12 districts in Kenya during 1986 through 1990 and 1994 through 1996. Districts were grouped according to the year in which TB notification rates started to increase. HIV prevalence in TB patients and changes in TB infection prevalence were compared between districts. RESULTS: Tuberculous infection prevalence rates increased strongly in districts where TB notification rates had increased before 1994 (odds ratio = 3.1, 95% confidence interval = 2.3, 4.1) but did not increase in districts where notification rates had increased more recently or not at all. HIV prevalence rates in TB patients were 50% in districts with an early increase in notification rates and 28% in the other study districts. CONCLUSIONS: Countries with an increasing prevalence of HIV infection will need additional resources for TB control, not only for current patients but also for the patients in additional cases arising from the increased risk of TB infection.
Full text
PDFSelected References
These references are in PubMed. This may not be the complete list of references from this article.
- Arnadottir T., Rieder H. L., Trébucq A., Waaler H. T. Guidelines for conducting tuberculin skin test surveys in high prevalence countries. Tuber Lung Dis. 1996 Jun;77 (Suppl 1):1–19. doi: 10.1016/s0962-8479(96)90127-6. [DOI] [PubMed] [Google Scholar]
- Bennett S., Woods T., Liyanage W. M., Smith D. L. A simplified general method for cluster-sample surveys of health in developing countries. World Health Stat Q. 1991;44(3):98–106. [PubMed] [Google Scholar]
- Bosman M. C., Swai O. B., Kwamanga D. O., Agwanda R., Idukitta G., Misljenovic O. National tuberculin survey of Kenya, 1986-1990. Int J Tuberc Lung Dis. 1998 Apr;2(4):272–280. [PubMed] [Google Scholar]
- Cantwell M. F., Binkin N. J. Tuberculosis in sub-Saharan Africa: a regional assessment of the impact of the human immunodeficiency virus and National Tuberculosis Control Program quality. Tuber Lung Dis. 1996 Jun;77(3):220–225. doi: 10.1016/s0962-8479(96)90004-0. [DOI] [PubMed] [Google Scholar]
- Cauthen G. M., Dooley S. W., Onorato I. M., Ihle W. W., Burr J. M., Bigler W. J., Witte J., Castro K. G. Transmission of Mycobacterium tuberculosis from tuberculosis patients with HIV infection or AIDS. Am J Epidemiol. 1996 Jul 1;144(1):69–77. doi: 10.1093/oxfordjournals.aje.a008856. [DOI] [PubMed] [Google Scholar]
- De Cock K. M., Binkin N. J., Zuber P. L., Tappero J. W., Castro K. G. Research issues involving HIV-associated tuberculosis in resource-poor countries. JAMA. 1996 Nov 13;276(18):1502–1507. doi: 10.1001/jama.276.18.1502. [DOI] [PubMed] [Google Scholar]
- De Cock K. M., Soro B., Coulibaly I. M., Lucas S. B. Tuberculosis and HIV infection in sub-Saharan Africa. JAMA. 1992 Sep 23;268(12):1581–1587. doi: 10.1001/jama.268.12.1581. [DOI] [PubMed] [Google Scholar]
- Elliott A. M., Hayes R. J., Halwiindi B., Luo N., Tembo G., Pobee J. O., Nunn P. P., McAdam K. P. The impact of HIV on infectiousness of pulmonary tuberculosis: a community study in Zambia. AIDS. 1993 Jul;7(7):981–987. doi: 10.1097/00002030-199307000-00012. [DOI] [PubMed] [Google Scholar]
- Fine P. E., Ponnighaus J. M., Maine N. The distribution and implications of BCG scars in northern Malawi. Bull World Health Organ. 1989;67(1):35–42. [PMC free article] [PubMed] [Google Scholar]
- Harries A. D. Tuberculosis and human immunodeficiency virus infection in developing countries. Lancet. 1990 Feb 17;335(8686):387–390. doi: 10.1016/0140-6736(90)90216-r. [DOI] [PubMed] [Google Scholar]
- Kok P. W. Cluster sampling for immunization coverage. Soc Sci Med. 1986;22(7):781–783. doi: 10.1016/0277-9536(86)90231-5. [DOI] [PubMed] [Google Scholar]
- Murray C. J., DeJonghe E., Chum H. J., Nyangulu D. S., Salomao A., Styblo K. Cost effectiveness of chemotherapy for pulmonary tuberculosis in three sub-Saharan African countries. Lancet. 1991 Nov 23;338(8778):1305–1308. doi: 10.1016/0140-6736(91)92600-7. [DOI] [PubMed] [Google Scholar]
- Murray C. J., Styblo K., Rouillon A. Tuberculosis in developing countries: burden, intervention and cost. Bull Int Union Tuberc Lung Dis. 1990 Mar;65(1):6–24. [PubMed] [Google Scholar]
- Nunn P., Mungai M., Nyamwaya J., Gicheha C., Brindle R. J., Dunn D. T., Githui W., Were J. O., McAdam K. P. The effect of human immunodeficiency virus type-1 on the infectiousness of tuberculosis. Tuber Lung Dis. 1994 Feb;75(1):25–32. doi: 10.1016/0962-8479(94)90098-1. [DOI] [PubMed] [Google Scholar]
- Perriëns J. H., Mukadi Y., Nunn P. Tuberculosis and HIV infection: implications for Africa. AIDS. 1991;5 (Suppl 1):S127–S133. [PubMed] [Google Scholar]
- ROELSGAARD E., IVERSEN E., BLOCHER C. TUBERCULOSIS IN TROPICAL AFRICA. AN EPIDEMIOLOGICAL STUDY. Bull World Health Organ. 1964;30:459–518. [PMC free article] [PubMed] [Google Scholar]
- ROELSGAARD E., NYBOE J. A tuberculosis survey in Kenya. Bull World Health Organ. 1961;25:851–870. [PMC free article] [PubMed] [Google Scholar]
- Rieder H. L. Methodological issues in the estimation of the tuberculosis problem from tuberculin surveys. Tuber Lung Dis. 1995 Apr;76(2):114–121. doi: 10.1016/0962-8479(95)90552-9. [DOI] [PubMed] [Google Scholar]
- Stýblo K., Meijer J., Sutherland I. Tuberculosis Surveillance Research Unit Report No. 1: the transmission of tubercle bacilli; its trend in a human population. Bull Int Union Tuberc. 1969 Aug;42:1–104. [PubMed] [Google Scholar]