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Main arrow Archive of previous Issues arrow ╣4 2012 (26) arrow HIV-associated TB-patients and changes in morbidity and mortality from TB and HIV-infection
HIV-associated TB-patients and changes in morbidity and mortality from TB and HIV-infection Print
Monday, 08 October 2012

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.áCorrelation coefficient value more than 0.21 (n=83) was consideredá significant.áP<0.05 for the error magnitude was considered ásignificant.

Results: Correlation analysis revealed cross-interchange of patients, separately entered iná 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 correspondingáindicators, 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.

References

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  4. Tsybikova E.B., Son I.M. Dinamika pokazateley zabolevayemosti i smertnosti ot tuberkuleza v Rossii v 2005 g. [Dynamics of TB morbidity and mortality indicators in Russia in 2005]. Problemy tuberkuleza i bolezney legkikh 2007;(3):8-11.
  5. Gandhi N.R., Moll A., Sturm A.W., Pawinski R., Covender T., Lalloo U., Zeller K., Andrews J., Friedland G. Extensively drug-resistant tuberculosis as a cause of death in patients co-infected with tuberculosis and HIV in a rural area of South Africa. Lancet 2006;368(6):1575-1580.
  6. Harries A.D., Zachariah R., Lawn S.D. Providing HIV care for co-infected tuberculosis patients: a perspective from sub-Saharan Africa. International Journal of Tuberculosis and Lung Disease 2008;(12):39-43.
  7. Implementing the WHO Stop TB strategy: a handbook for national tuberculosis control program. Geneva. World Health Organization. [Internet]. 2008 [cited 2012 Apr 19]. Available from: http://www.who.int/hiv/pub/ meetings-report
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