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Infectious Diseases
and STD-AIDS
Infectious Diseases and STD-AIDS 2018
Journal of Transmitted Diseases and Immunity
ISSN 2471-8084
A p r i l 2 6 , 2 7 2 0 1 8
R o m e , I t a l y
Page 71
J Transm Dis Immun 2018 Volume 2
DOI: 10.21767/2573-0320-C1-003
T
he total number of tuberculosis cases in the world is increasing and the HIV epidemic is implicated for this increased incidence.
Nigeria is ranked in top five countries for TB deaths worldwide. Due to the increasing level of immunocompromised individuals
resulting from diseases like HIV/AIDS, other non-tuberculous Mycobacteria (NTM) are beginning to thrive and cause tuberculous
infections. The information on the contribution of non-tuberculous Mycobacteria (NTM) to Mycobacterial infections in Africa
including Nigeria is scarce due to limited laboratory culture for its isolation and identification. Studies on the co-infectivity of
HIV and atypical Mycobacteria in Nsukka L.G.A. were carried out. Two hundred cases (100 HIV negative and 100 HIV positive
patients) were identified out of which 46.5% were male and 53.5% were female. The age ranged between 15 and 71 with mean
age of 37.5 years. HIV antibodies were screened using two HIV test kits: the Determine (for preliminary test) and the Gold which
was used to check for consistency. CD4+ count was carried out using cytometry (CyFlow®). Acid fast bacilli (AFB) were detected
by means of sputum smear microscopy using Ziehl-Neelson staining technique. AFB positive samples were subjected to nested
PCR for species identification. T-test was employed to check for statistical significance between the mean prevalence in test and
control groups and CD4 count of HIV single infection and co infection with TB. Correlation analysis was also employed to check
for relationship between the demographic characteristics and the distribution of the disease. A preponderance of HIV infection
was observed among the age group 21-50 years (72.5%) with overall HIV prevalence of 19.4%. The highest AFB prevalence of
26.6% was observed among patients aged 21-30 years, with overall prevalence of 24%. About 79.1% of TB infection occurred
at CD4 count less than 400 cells/µL. Molecular analysis of the samples (using nested PCR) showed 97 (78.9%)
M. tuberculosis
,
14 (11.4%) M. bovis and 10 (8.1%) NTM. The NTM identified was M. avium complex. The prevalence rate of TB/HIV co-infection
was 24 (24%) out of which 14 (53.8%) were
M. tuberculosis
, 5 (20.8%) were M. bovis and 3 (12.5%) were NTM. The highest NTM
prevalence of 66.7% was observed among patients aged 21-30 years in the HIV positive group while the highest prevalence of
42.8% was observed among 41-50 years in the HIV negative group. TB co-infection was significantly associated with CD4+ cell
count (P<0.05). Rural settlers and those with lower education were at higher risk to have TB co-infection with HIV (RR=1.40,
P=0.002) and (RR=3.17, P=0.01) respectively. The data obtained in this study underscores the role of non-tuberculous AFB
organisms in pulmonary tuberculosis especially in HIV patients, and is suggestive of the public health implications of DOTS
administration without proper discrimination between TB and NTM. Introduction of molecular screening assays that include rapid
detection of NTM infections in high burden resource limited settings like Nigeria should be a priority for strengthening the public
health response.
marie.dibua@unn.edu.ngStudies on the co-infectivity of HIV and atypical
Mycobacteria in Nsukka local government areas
of Enugu state
Uju Marie-Esther Dibua
University of Nigeria, Nsukka, Nigeria