E.B. Tzybikova
Federal Research Institute for Health Organization and Informatics of
Ministry of Health and Social Development of the Russian Federation,
Moscow
Summary. Background: In the first decade of XXI-st
century, a tendency towards diminished TB-incidence was taking shape in
Russia, while, on the other hand, there occurred an overwhelming
increase in morbidity with HIV-associated tuberculosis: 741% growth of
overall registered cases of such patients in 2001 in comparison with
2004. This pattern of co-infection was propelling a new pathway for
rapid growth of morbidity and mortality both from TB and HIV-infection.
Aim: to survey the structure of the pool of HIV-TB co-infected
patients for the evaluation of their impact upon main indicators of
morbidity and mortality from TB and from HIV-infection, separately.
Materials and Methods: Annual account forms Nos. 8, 33, and 61
recommended by a Decree issued by Statictical Board of Russia (SBR) and
confirmed for recommended use by an Order No.50 of the Ministry of
Public Health... of the Russian Federation, as well as SBR's official
data on gender and age structure of the population - all pertaining to
years 2000-2011 - were enrolled for this study into main indicators of
TB and HIV situations. For correlation analysis, Pearson coefficients
were being calculated. Correlation coefficient value more than 0.21
(n=83) was considered significant. P<0.05 for the error magnitude
was considered significant.
Results: Correlation analysis revealed cross-interchange of patients,
separately entered in TB registry/HIV registry, that was leading to a
situation when main indicators derived from these two registries were
inevitably corrupted. Thus, a growth in fatal cases from co-infection
brought about an increased HIV-infection caused mortality, from the one
hand, and a decreased TB caused mortality, from the other. Co-infection
data when entered into overall estimations only but disturbed
consequences in changes of the indicators of morbidity and mortality
from tuberculosis, and created confusing tendencies in the development
of established indicators.
Conclusions: The pool of co-infected patients was being filled up
through cross-interchange of both (TB and HIV) registries and their
corresponding indicators, as well. Increased number of cases with
co-infection resulted in increased values of indicators of morbidity
both for TB and HIV. Increased number of co-infection fatality
statistically resulted in increased HIV mortality and decreased TB
mortality.
Keywords. Tuberculosis; HIV-infection; HIV-associated TB; structure of co-infected pool; fatality; mortality; correlation analysis.
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