Prevalence of Tuberculosis, HIV and Respiratory Symptoms in Two Zambian Communities Implications for Tuberculosis Control in the Era of HIV 英文参考文献.docVIP

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Prevalence of Tuberculosis, HIV and Respiratory Symptoms in Two Zambian Communities Implications for Tuberculosis Control in the Era of HIV 英文参考文献.doc

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Prevalence of Tuberculosis, HIV and Respiratory Symptoms in Two Zambian Communities Implications for Tuberculosis Control in the Era of HIV 英文参考文献

PrevalenceofTuberculosis,HIVandRespiratory SymptomsinTwoZambianCommunities:Implications forTuberculosisControlintheEraofHIV HelenAyles1,2*,AlbertusSchaap2,3,AmosNota2,CharalambosSismanidis3,RuthTembwe4{,PetraDe Haas1,2,MondeMuyoyeta2,NuldaBeyers5,PeterGodfrey-Faussett1 fortheZAMSTARStudyTeam 1Department of Infectious and Tropical Diseases, London School of Hygiene Tropical Medicine, London, United Kingdom, 2ZAMBART Project, Ridgeway Campus, UniversityofZambia,Lusaka,Zambia,3DepartmentofEpidemiologyandPopulationHealth,LondonSchoolofHygieneTropicalMedicine,London,UnitedKingdom, 4ChestDiseasesLaboratory,Lusaka,Zambia,5DesmondTutuTBCentre,StellenboschUniversity,Tygerberg,SouthAfrica Abstract Background: The Stop TB Partnership target for tuberculosis is to have reduced the prevalence of tuberculosis by 50% comparing 2015 to 1990. This target is challenging as few prevalence surveys have been conducted, especially in high burdentuberculosisandHIVcountries.CurrenttuberculosiscontrolstrategiesinhighHIVprevalentsettingsaretherefore based on limited epidemiological evidence and more evidence is needed from community-based surveys to inform improvedpolicyformulation. MethodsandFindings:8044adultsweresampledfrom2sub-districts(wards)inLusakaprovince,Zambia.Questionnaires were used to screen for symptoms, respiratory samples were obtained for culture and oral secretions collected for HIV testing. 79 individuals were found to have Mycobacterium tuberculosis in their sputum, giving an adjusted overall prevalenceoftuberculosisof870/100,000(95%CI570–1160/100,000).TheadjustedoverallprevalenceofHIVwas28.61% (95%CI26.04–31.19).HIV-infectionwassignificantlyassociatedwithprevalenttuberculosis(AdjOR2.3,95%CI1.42–3.74) andthepopulationattributablefractionofHIVforprevalenttuberculosiswas36%.Symptomssuchasprolongedcough(adj OR12.72,95%CI7.05–22.94)andfever(AdjOR2.04,95%CI1.23–3.39),wereassociatedwithprevalenttuberculosis,but8 (10%) individuals with prevalent tuberculosis denied having