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Comparison of trends in tuberculosis incidence among adults living with HIV and adults without HIV--Kenya, 1998-2012.

Yuen CM, Weyenga HO, Kim AA, Malika T, Muttai H, Katana A, Nganga L, Cain KP, De Cock KM - PLoS ONE (2014)

Bottom Line: Tuberculosis incidence among both adults with HIV and adults without HIV increased during 1998-2004 then remained relatively stable until 2007.In 2012, tuberculosis incidence among adults with HIV (1,839-1,936 cases/100,000 population) was still eight times as high as among adults without HIV (231-238 cases/100,000 population), and approximately one third of tuberculosis cases were attributable to HIV.Early diagnosis of HIV, early initiation of antiretroviral therapy, regular screening for tuberculosis, and isoniazid preventive therapy among persons with HIV, as well as tuberculosis control in the general population, are required to address these issues.

View Article: PubMed Central - PubMed

Affiliation: Epidemic Intelligence Service, assigned to Division of Tuberculosis Elimination, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.

ABSTRACT

Background: In Kenya, the comparative incidences of tuberculosis among persons with and without HIV have not been described, and the differential impact of public health interventions on tuberculosis incidence in the two groups is unknown.

Methods: We estimated annual tuberculosis incidence stratified by HIV status during 2006-2012 based on the numbers of reported tuberculosis patients with and without HIV infection, the prevalence of HIV infection in the general population, and the total population. We also made crude estimates of annual tuberculosis incidence stratified by HIV status during 1998-2012 by assuming a constant ratio of HIV prevalence among tuberculosis patients compared to the general population.

Results: Tuberculosis incidence among both adults with HIV and adults without HIV increased during 1998-2004 then remained relatively stable until 2007. During 2007-2012, tuberculosis incidence declined by 28-44% among adults with HIV and by 11-26% among adults without HIV, concurrent with an increase in antiretroviral therapy uptake. In 2012, tuberculosis incidence among adults with HIV (1,839-1,936 cases/100,000 population) was still eight times as high as among adults without HIV (231-238 cases/100,000 population), and approximately one third of tuberculosis cases were attributable to HIV.

Conclusions: Although tuberculosis incidence has declined among adults with and without HIV, the persistent high incidence of tuberculosis among those with HIV and the disparity between the two groups are concerning. Early diagnosis of HIV, early initiation of antiretroviral therapy, regular screening for tuberculosis, and isoniazid preventive therapy among persons with HIV, as well as tuberculosis control in the general population, are required to address these issues.

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Estimates of tuberculosis attributable to HIV among adults – Kenya, 2006–2012.Upper- and lower-bound estimates of population attributable fraction of incident tuberculosis attributable to HIV among adults aged 15–64 years.
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pone-0099880-g003: Estimates of tuberculosis attributable to HIV among adults – Kenya, 2006–2012.Upper- and lower-bound estimates of population attributable fraction of incident tuberculosis attributable to HIV among adults aged 15–64 years.

Mentions: In 2012, 32–34% of tuberculosis cases among adults aged 15–64 years in Kenya were attributable to HIV (Figure 3). However, because of the large difference between upper- and lower-bound incidence estimates for the early years of the analysis period, it is unclear how the population attributable fraction has changed during 2006–2012.


Comparison of trends in tuberculosis incidence among adults living with HIV and adults without HIV--Kenya, 1998-2012.

Yuen CM, Weyenga HO, Kim AA, Malika T, Muttai H, Katana A, Nganga L, Cain KP, De Cock KM - PLoS ONE (2014)

Estimates of tuberculosis attributable to HIV among adults – Kenya, 2006–2012.Upper- and lower-bound estimates of population attributable fraction of incident tuberculosis attributable to HIV among adults aged 15–64 years.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4061026&req=5

pone-0099880-g003: Estimates of tuberculosis attributable to HIV among adults – Kenya, 2006–2012.Upper- and lower-bound estimates of population attributable fraction of incident tuberculosis attributable to HIV among adults aged 15–64 years.
Mentions: In 2012, 32–34% of tuberculosis cases among adults aged 15–64 years in Kenya were attributable to HIV (Figure 3). However, because of the large difference between upper- and lower-bound incidence estimates for the early years of the analysis period, it is unclear how the population attributable fraction has changed during 2006–2012.

Bottom Line: Tuberculosis incidence among both adults with HIV and adults without HIV increased during 1998-2004 then remained relatively stable until 2007.In 2012, tuberculosis incidence among adults with HIV (1,839-1,936 cases/100,000 population) was still eight times as high as among adults without HIV (231-238 cases/100,000 population), and approximately one third of tuberculosis cases were attributable to HIV.Early diagnosis of HIV, early initiation of antiretroviral therapy, regular screening for tuberculosis, and isoniazid preventive therapy among persons with HIV, as well as tuberculosis control in the general population, are required to address these issues.

View Article: PubMed Central - PubMed

Affiliation: Epidemic Intelligence Service, assigned to Division of Tuberculosis Elimination, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.

ABSTRACT

Background: In Kenya, the comparative incidences of tuberculosis among persons with and without HIV have not been described, and the differential impact of public health interventions on tuberculosis incidence in the two groups is unknown.

Methods: We estimated annual tuberculosis incidence stratified by HIV status during 2006-2012 based on the numbers of reported tuberculosis patients with and without HIV infection, the prevalence of HIV infection in the general population, and the total population. We also made crude estimates of annual tuberculosis incidence stratified by HIV status during 1998-2012 by assuming a constant ratio of HIV prevalence among tuberculosis patients compared to the general population.

Results: Tuberculosis incidence among both adults with HIV and adults without HIV increased during 1998-2004 then remained relatively stable until 2007. During 2007-2012, tuberculosis incidence declined by 28-44% among adults with HIV and by 11-26% among adults without HIV, concurrent with an increase in antiretroviral therapy uptake. In 2012, tuberculosis incidence among adults with HIV (1,839-1,936 cases/100,000 population) was still eight times as high as among adults without HIV (231-238 cases/100,000 population), and approximately one third of tuberculosis cases were attributable to HIV.

Conclusions: Although tuberculosis incidence has declined among adults with and without HIV, the persistent high incidence of tuberculosis among those with HIV and the disparity between the two groups are concerning. Early diagnosis of HIV, early initiation of antiretroviral therapy, regular screening for tuberculosis, and isoniazid preventive therapy among persons with HIV, as well as tuberculosis control in the general population, are required to address these issues.

Show MeSH
Related in: MedlinePlus