PREVALENCE OF TUBERCULOSIS AND HIV/AIDS CO-INFECTION AMONG PATIENTS ATTENDING DIRECTLY OBSERVED TREATMENT SHORT-COURSE (DOTS) CENTRES IN RIVERS STATE, NIGERIA (2004 – 2008)

AUTHOR: FRANK, THANKGOD CHUKWUDI

DEPARTMENT: HUMAN KINETICS AND HEALTH EDUCATION

AFFILIATION: NNAMDI AZIKIWE UNIVERSITY, AWKA.

Tuberculosis (TB) and HIV have become major public health problems in many countries including Nigeria. Of a serious concern is that tuberculosis situation in Nigeria has been worsened by the prevalence of HIV and AIDS (NTBLC, 2006). The condition has given rise to a new epidemic of TB and HIV co-infection – a combination of two lethal diseases already occurring in epidemic proportions, which is contributing to the rising mortality and morbidity rates in Rivers State ( Okeh, 2009). The purpose of the study was therefore, to determine the prevalence rates of TB and HIV co-infection among patients that attended the Directly Observed Treatment Short-course (DOTS) centres in Rivers State, Nigeria from 2004 to 2008. The study aimed to address the apparent lack of data and limited knowledge on the rate of TB infections in HIV patients or the rate of HIV infections on TB patients in the State. The study also examined if the prevalence or distribution of the TB and HIV co-infected cases in the State were related to the independent variables of gender, age, marital status, place of settlement and the sexual practices / behaviours of the patients. Six research questions and the corresponding research hypotheses were postulated to guide the Study. The study adopted a descriptive, retrospective epidemiological survey design. The entire target population consisting of 3,324 case files of patients aged 15-60 years that were treated in the 13 microscopic DOTS centres in Rivers State from 2004 to 2008 was studied. The uniform data form, a standardized instrument in current use in health facilities was used for the data collection. Three experts including the supervisor validated the instrument, and confirmed it as adequate in content. No changes or modification was made on the instrument; hence its reliability was intact. The required data and information were extracted from the case files of all those identified to be co-infected with TB and HIV using this instrument. Percentages based on the yearly prevalence were used in answering the research questions; while the Chi–Square statistic was used to test the hypotheses at 0.05 levels of significance. The major findings included among others; (i) an overall prevalence rate of 31.1 percent for TB and HIV co-infected cases; with statistically significant differences (p> 0.05) in the distribution of the co-infected cases from 2004 to 2008; (ii) although distribution of the coinfected cases depended significantly (p< 0.05) on the patients’ gender, marital status and place of settlement; no such relationship (p> 0.05) were found with the patients’ ages or sexual practices/behaviours. The Study concluded that; (i) the prevalence rate of 31.1 percent was relatively high when compared to other places in the country and/or in the continents, (ii) the female gender in the population were far more ravaged by TB and HIV co-infection than their male counterpart in the State, (iii) none of the age groups studied appeared exempted or worse affected than the other , (iv) unmarried lifestyle was a major risk factor while sexual practices/behaviours was not sacrosanct in contributing to the high prevalence rate of the coinfection in the state, (v) the co-infection disease burden was relatively high on the rural populations than on the urban (p < 0.05). Pertinent recommendations made include, establishing more DOTS centres in the rural areas; organizing massive awareness campaigns for identified vulnerable age groups, the sexually active groups, as well as planning and implementing preventive and intervention measures to curb risky sexual practices / behaviours.

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