Asian Journal of Medical Sciences 5(1): 01-02, 2013
ISSN: 2040-8765; e-ISSN: 2040-8773
© Maxwell Scientific Organization, 2013
Submitted: April 17, 2012
Accepted: July 18, 2012
Published: February 25, 2013
Epidemological Association of Tuberculosis and HIV in Visakhapatnam District
1
M. Padma Sundari and 2B. Dharani Priya
1
Department of Microbiology,
2
Department of Human Genetics, Andhra University, Visakhapatnam, India
Abstract: The object of our study is to observe the epidemiological distribution and association of Tuberculosis
(TB) co-infection with HIV among the Visakhapatnam zone of Andhrapradesh. It is mainly due to Tuberculosis and
HIV has been closely linked and HIV infection has contributed to a significant increase in the worldwide incidence
of tuberculosis. According to WHO, the proportion of TB cases co-infected with HIV was also found rising being 210 times greater for 1997 estimates than for 19902. By producing a progressive decline in cell-mediated immunity,
HIV alters the pathogenesis of tuberculosis, greatly increasing the risk of developing disease in co-infected
individuals and leading to more frequent extra pulmonary involvement and atypical radiographic manifestations. In
the present analysis it was found that in new smear pulmonary TB cases; there was an increase trend in number of
cases in both male and female. According to smear positive and smear negative TB cases, male are more prone to
TB (71.77% smear positive and 63.83% smear negative) than female (28.22% smear positive and 36.16% smear
negative). In all the TB cases registered through RNTCP 4186 TB Patients are reported to be tested for HIV before
or during the treatment. Out of those 4,186 cases, 558 are HIV positive.
Keywords: Epidemiology, HIV, Tuberculosis (TB), Visakhapatnam district
INTRODUCTION
HIV infected person with tuberculin skin test reaction
of 5 mm in Italy (Antonnucci et al., 1995).
Keeping these studies in mind we undertook this
study to find the epidemiological and clinical features
of TB patients in Visakhapatnam district.
Tuberculosis (TB) remains number one killer
infectious disease affecting adults in developing
countries developing countries. India is a home for 3.4
million TB patients which accounts for 1/5th of the
global figure. The proportion of TB cases co-infected
with HIV was also found rising being 2-10 times
greater for 1997 estimates (Chakraborty, 2004; Dye
et al., 1999).
India had a National Tuberculosis Program
(NTPC) since 1960’s. In spite of that there were serious
limitations in the diagnostic paradigm and treatment
regimens. In 1993; the NTP program in INDIA was
strengthened in form of Revised National Tuberculosis
Program (RNTCP) Wikipedia encyclopedia.
TB situation in an area is measured in terms of:
•
•
•
MATERIALS AND METHODS
The epidemiological survey design provided with
TB testing of Visakhapatnam district of year 2009, with
lineage to demographic clinical data of these cases. The
data was collected from district TB control office from
Visakhapatnam TB hospital. The survey was
undertaken in order to determine the impact of HIV on
present TB cases in Visakhapatnam district. Diagnosis
of TB is based on sputum smear microscopy and chest
radiography.
Staining technique: In this Technique two sputum
samples are collected over two days (as spot morning)
from chest symptomatic and when stained with Zeihl
Nelseen stain, the acid fast bacilli stained bright red and
stand out clearly against a blue background. This test
specify 99% test sensitivity.
In situation where the two smears are negative then
chest and X-ray is being performed.
Death, among the known cases of TB
Prevalence and incidence of infection
Person’s diseases at a point of time in given
community
The importance of tuberculosis to global HIV
epidemic is enormous. TB is leading cause of HIV
related deaths worldwide. In 2008, there were an
estimated 1.4 million new cases of TB which accounted
for 23% of AIDS related death. The risk of tuberculosis
among HIV infections is closely related with number of
CD4+ lymphocytes, as it was shown in study among
Chest radiography: It is a regularly performed
investigation. Diffused Pulmonary infiltrates is the
dominant radiological presentation. In presence of
radiographic lesion suggest of TB with negative sputum
smears in a patients.
Corresponding Author: M. Padma Sundari, Department of Microbiology, Andhra University, Visakhapatnam, India
1
Asian J. Med. Sci., 5(1): 01-02, 2013
Table 1: Age wise new smear TB cases
Age
Male
(%)
0-14
10
0.53
15-24
271
14.53
25-34
347
18.61
35-44
462
24.80
45-54
396
21.24
55-64
277
14.78
65>
101
5.41
Total
1864
99.90
Table 2: Smear positive and smear negative
female patients
Smear positive
---------------------------------Sex
Number
(%)
Male
1864
71.77
Female
733
28.22
Total
2597
99.99
Female
29
229
174
128
97
55
51
763
cases, 558 are HIV positive (Table 3). A study in
Andhra Pradesh showed that a third of TB patients
treated by private medical practitioners had coinfections of TB and HIV (Jain et al., 1996). A similar
study conducted by Dakshina Kannada district of
Karnataka revealed out of 250 TB cases 25 cases (10%)
were HIV positive (Acharya and Majra, 2007). Sero
prevalence of HIV among TB patients in a study
conducted in Jammu and Kashmir was 1.6% (Bahl
et al., 2007).
(%)
3.80
30.01
22.80
16.77
12.71
7.21
6.68
99.98
TB cases in male and
Smear negative
-----------------------Number
(%)
858
63.83
486
36.16
1344
99.99
Table 3: HIV tuberculosis cases
Total cases tested for HIV
HIV positive cases
4186
558
ACKNOWLEDGMENT
The first author’s thanks TB district control office
for providing epidemiological data.
REFERENCES
(%)
13.33
Acharya, D. and J.P.A. Majra, 2007. Clinical
epidemiological study of tuberculosis among
hospitalized cases in Dakshina Kannada district of
Karnataka. NTI Bull., 42(3-4): 43-46.
Antonnucci, G., T. Girardi, M.C. Raviglime and
G. Ippolito, 1995. Risk infection for TB in HIV
infection persons: A prospective chort study.
J. Am. Med. Assoc., 274: 143.
Bahl, R., B. Singh and R. Singh, 2007. Prevalence of
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Chakraborty,
A.K.,
2004.
Epidemiology
of
tuberculosis: Current status in India. Retrieved
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http://readermeter.org/Chakraborty.A_K/
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Dye, C., S. Scheele, P. Dolin, V. Pathania and
M.C. Ravi-Glione, 1999. Global burden of TB:
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C.N. Paramsivan,
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Ranganathan
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RESULTS AND DISCUSSION
A total no. of 4,996 TB cases were reported
through RNTCP statistics in Visakhapatnam district
during the year 2009 (data collected from district TB
office). The number of TB patients as per present study
is 15 years age are more, where as within 14 years, it is
less reported (Table 1). Low prevalence in children
below 14 years may be due to BCG vaccination as it
provides protection against childhood TB. These
observations can be related with that of NFHS-2
(13.73/1000 in 60 years and 1.53/1000 in 0-14 years
and survey carried out in urban population of Delhi
(highest prevalence in the +55 age group (11.98%)
(Study of Epidemiology of TB in Urban Population of
Delhi, 1999; National Family Health Survey-2 India,
1998-1999). In new smear pulmonary TB cases; there is
increase trend in number of cases in both male and
female. Highest percentage was reported in male in age
group 35-44 (24.78%) and in female in age group of
25-34 (22.80%). In further age group there is decrease
in TB patients in both genders and age.
According to smear positive and smear negative
TB cases, male are prone more to TB (71.77% smear
positive and 63.83% smear negative) than female
(28.22% smear positive and 36.16% smear negative)
(Table 2). A study carried out in Raichur district of
Karnataka showed more TB cases in male (11.9%) than
females (7.1%) (National Family Health Survey-2
India, 1998-1999). NHFS-2 also reported higher
occurrence of TB among male (6.24/1000) than female
(4.6/1000) (Gopi et al., 1997).
In all the TB cases registered through RNTCP
4186 TB patients are reported to be tested for HIV
before or during the treatment. Out of those 4,186
2