A low CD4 count, a history of sexually transmitted infections (STIs), and past or current pulmonary asthma were among the many independent risk factors for tuberculosis identified in a cross-sectional study in Burkina Faso. Some TB risk factors differed by region.
TB remains the leading cause of death among people with HIV in many parts of sub-Saharan Africa. Researchers used stepwise logistic regression analysis to pinpoint TB risk factors in a study of 734 people with HIV infection in Burkina Faso, including 181 (24.7%) with TB.
Burkina Faso is a landlocked country in West Africa, north of Côte d’Ivoire, Ghana, Togo, and Benin. UNAIDS estimates that Burkina Faso had an adult HIV prevalence of 1.1% in 2011.
The research team recruited consecutive HIV patients attending TB hospitals or HIV clinics from August through October 2010. Recruitment took place in two regions, Hauts-Bassins and Centre. Those regions contributed 53.4% and 46.6% of study participants.
The study identified seven factors independently associated with TB in both regions studied:
• Urban residence
• TB history
• More people living in the household
• Poor geographic access to care
• CD4 count below 200 cells/μL
• History of STIs
• Past or current pulmonary asthma
Among people living in the Hauts-Bassins region, lack of education and arterial hypertension also independently raised the risk of TB. Among people living in the Centre region, male gender, jobs not in the private and public sector, and past or present cardiovascular disease made TB more likely.
The researchers conclude that “common and different risk factors for TB were identified for people living with HIV/AIDS in the Hauts-Bassins and Centre regions.” The government plans to incorporate this information into the HIV/TB control program.
Source: Ziemlé Clément Méda, Issiaka Sombié, Olivier W.C. Sanon, Daouda Maré, Donald E. Morisky, Yi-Ming Arthur Chen. Risk factors of tuberculosis infection among HIV/AIDS patients in Burkina Faso. AIDS Research and Human Retroviruses. 2013; 29: 1045-1055.
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Source: IAS