The epidemiological profile of tuberculosis in southern Brazil in times of AIDS
Abstract:SETTING: Urban area in southern Brazil.
OBJECTIVE: To investigate human immunodeficiency virus (HIV) co-infection among new cases of tuberculosis recorded in 2000 in Porto Alegre, Brazil.
DESIGN: Cross-sectional population-based study.
RESULTS: Among 1713 new tuberculosis cases, HIV testing was not available for 29.8% and results were unknown for 1.8%. Of 1171 with known results, 47% had HIV co-infection. HIV seropositivity was 44% higher in males. The 15–59 years age group had 3.4 times more seropositive cases than the group aged >59 years. Individuals with <8 years of schooling presented 57% more co-infection. HIV positivity was twice as frequent in extra-pulmonary and combined forms of tuberculosis as in pulmonary forms. Hospitalization was 2.4 times more common in HIV-positive individuals. The overall cure rate was 69.8%, while in co-infected patients it was 43.9%. The determinants of risk of death from tuberculosis included <8 years of schooling (PR 2.2, 95%CI 1.2–3.7), HIV seropositivity (PR 8.0, 95%CI 5.0–12.9), combined pulmonary and extra-pulmonary tuberculosis (PR 1.7, 95%CI 1.2–2.5) and diagnosis during admission rather than in out-patient clinics (PR 5.4, 95%CI 2.9–10.1).
CONCLUSIONS: The co-occurrence of tuberculosis and HIV/AIDS indicates a need to integrate the control programs for these two diseases. The health care system should invest in early diagnosis and adherence to treatment for both diseases.
Document Type: Regular Paper
Affiliations: 1: School of Medicine and Master's Program in Collective Health, Universidade Luterana do Brasil (ULBRA), Canoas, RS, Brazil; and Porto Alegre City Department of Health, Porto Alegre, RS, Brazil 2: Lung Health Coordination, Rio Grande do Sul State Department of Health, Porto Alegre, RS, Brazil
Publication date: June 1, 2004
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