Seroprevalence of human immunodeficiency virus infection among tuberculosis patients in the Nylon district hospital tuberculosis treatment centre.

BACKGROUND: Tuberculosis (TB) incidence in Cameroon is high with 32% of adult TB patients, all forms, co-infected with HIV. The Nylon District Hospital in Douala runs a centre for the diagnosis and treatment of TB since 2001 and a pioneer Human Immunodeficiency Virus (HIV)/Acquired Immune deficiency Syndrome (AIDS) management programme at district level since 2000.

OBJECTIVE: To determine the prevalence of HIV infection in TB patients from 2003 to 2006 and to analyse the pattern of TB/HIV co-infection rate over time.

DESIGN: A retrospective study.

SETTING: Nylon District Hospital, Douala, Cameroon.

RESULTS: The prevalence of HIV infection in TB patients was 51.6%. This was greater for patients living out of the Nylon Health District (P = 0.001). Smear positive pulmonary tuberculosis (SPPT) was the most frequent (65%) form of TB diagnosed but extrapulmonary tuberculosis (EPT) and smear negative pulmonary tuberculosis (SNPT) were more frequently associated with HIV co-infection (80% and 68.6% respectively). While men and women presented equally with TB, women (61.4%) were significantly (P < 0.0001) more TB/HIV co-infected than men (42%). The co-infection rate was highest among individuals aged 25-44 years (61.4%) and least among the 0-24 years age group (22.5%). The increase in TB/HIV co-infection rate is monotonic over time with a stronger trend among females aged 25-44 years (P = 0.037) and above 45 years (P = 0.001).

CONCLUSION: The NDH selectively attracted HIV positive patients to adhere to their HIV programme. The creation of HIV/AIDS treatment units in institutions providing TB diagnosis and treatment services will reduce the movement of TB/HIV co-infected patients across provinces and health districts as well as enhancing TB/HIV co-infection diagnosis and notification.