Epidémiologie de la coinfection VIH/TB en RDC et dans la Province du Sud-Kivu. Etude des opportunités manquées
(2013) 33ème Réunion interdisciplinaire de chimiothérapie anti-infectieuse — Location: Paris (21.November.2013)
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- Background: HIV testing is recommended for TB patients. We here describe the epidemiology of HIV-TB co-infection in the South-Kivu Province, DRC, and study missed opportunities (MO) for HIV screening among TB patients. Methods: We used data on TB diagnosis and HIV screening from the surveillance system of the National TB Program reporting system, which compiles data from all 78 health care centres in the province. We used negative binomial regression to obtain TB incidence risk ratios by area or population groups and used binomial regression to obtain risk ratios (RR) for HIV prevalence and HIV MO by area, year and population groups. Results: There were 4844, 4993 and 5204 TB diagnoses made in 2010, 2011 and 2012 respectively. The annual incidence rate/100,000 increased from 89.0 (95% confidence interval (CI) 86.5 – 91.6) in 2010 to 92.3 (95%CI 89.7 – 94.9) in 2012. Incidence was highest in mining and urban areas compared to semi-rural and rural areas. Fifty-nine (76%) centres offered HIV screening in 2010 compared to 53 (70%) in 2012. HIV prevalence among TB patients decreased by 30% during the study period, from 11.3% in 2010 to 7.9% in 2012 (p<0.001), and was significantly higher in urban areas. The proportion of MO for HIV screening among TB patients increased from 26.0% in 2010 to 39.6% in 2012 (p<0.001). There were fewer MO in centres providing regular tests throughout the period than those offering irregular services (RR 0.56, p<0.001). Conclusions: TB incidence and the prevalence of HIV-TB co-infection are both high in South-Kivu, but more than 40% of TB patients are not screened. Our results suggest that irregular support of HIV tests to health centres, probably due to the ongoing humanitarian crisis, impacts the quality of services. Results of this study are important for TB-HIV health service planning in poor high burden settings.
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Mulume, E., le Polain de Waroux, O., & André, E. (2013). Epidémiologie de la coinfection VIH/TB en RDC et dans la Province du Sud-Kivu. Etude des opportunités manquées. 33ème Réunion interdisciplinaire de chimiothérapie anti-infectieuse, Paris. https://hdl.handle.net/2078.5/84402