Seroprevalence of human immunodeficiency virus infection among tuberculosis patients in the Nylon district hospital tuberculosis treatment centre.

BACKGROUND Tuberculosis (TB) incidence in Cameroon is high with 32% of adult TB patients, all forms, co-infected with HIV. The Nylon District Hospital in Douala runs a centre for the diagnosis and treatment of TB since 2001 and a pioneer Human Immunodeficiency Virus (HIV)/Acquired Immune deficiency Syndrome (AIDS) management programme at district level since 2000. OBJECTIVE To determine the prevalence of HIV infection in TB patients from 2003 to 2006 and to analyse the pattern of TB/HIV co-infection rate over time. DESIGN A retrospective study. SETTING Nylon District Hospital, Douala, Cameroon. RESULTS The prevalence of HIV infection in TB patients was 51.6%. This was greater for patients living out of the Nylon Health District (P = 0.001). Smear positive pulmonary tuberculosis (SPPT) was the most frequent (65%) form of TB diagnosed but extrapulmonary tuberculosis (EPT) and smear negative pulmonary tuberculosis (SNPT) were more frequently associated with HIV co-infection (80% and 68.6% respectively). While men and women presented equally with TB, women (61.4%) were significantly (P < 0.0001) more TB/HIV co-infected than men (42%). The co-infection rate was highest among individuals aged 25-44 years (61.4%) and least among the 0-24 years age group (22.5%). The increase in TB/HIV co-infection rate is monotonic over time with a stronger trend among females aged 25-44 years (P = 0.037) and above 45 years (P = 0.001). CONCLUSION The NDH selectively attracted HIV positive patients to adhere to their HIV programme. The creation of HIV/AIDS treatment units in institutions providing TB diagnosis and treatment services will reduce the movement of TB/HIV co-infected patients across provinces and health districts as well as enhancing TB/HIV co-infection diagnosis and notification.