19 Ninan Etal
19 Ninan Etal
19 Ninan Etal
Copyright @2015
ISSN: 2319-5886
Accepted: 5th Jun 2015
Ninan et al.,
Ninan et al.,
Sex
Marital
Status
Occupational
status
HIV status of
spouse(n=41)
Characteristics
15-24
25-34
35-44
45 and above
Male
Female
Married/ Unmarried/
Separated/Divorced
Spouse died
Manual labourer
Driver
Small business
Army/Police
Housewife
Others
Positive
Negative
Unknown
%
6%
44%
44%
6%
92%
8%
82%
18%
0
54%
22%
10%
2%
8%
4%
58.5%
29.2%
12.2%
RESULTS
A total of 50 patients with HIV/TB co-infection and
with extra-pulmonary manifestation of tuberculosis
infection, were included in the study. The maximum
numbers of participants were from the age group 2534 years (44%) and 35-44 years (44%). Males
constituted 92% of the total study participants and
82% of the participants were married. Most of the
study participants were manual labourers (54%) and
drivers (22%). Twenty four (58.5%) of the currently
married participants had their spouses with a positive
HIV status, while it was negative for 29.2% and
unknown for 12.2%. [Table 1]
Number
3
22
22
3
46
4
41
9
0
27
11
5
1
4
2
24
12
5
History of Migration
History of
Imprisonment
Contact with
Commercial Sex
Worker
Men Having Sex with
Men (MSM) (n=46)
Intravenous drug user
Characteristic
Alcohol
Tobacco
Cannabis
Hallucinogens
Yes
No
Yes
No
Yes
No
Number(%)
44(88%)
40(80%)
4(8%)
6(12%)
35(70%)
15(30%)
5 (10%)
45(90%)
38(76%)
12(24%)
Yes
No
Yes
No
0
46(100%)
6(12%)
44(88%)
Ninan et al.,
Number
7
5
4
1
1
1
2
1
1
1
1
%
28%
20%
16%
4%
4%
4%
8%
4%
4%
4%
4%
DISCUSSION
The study reveals a familiar trend seen in other parts
of the world, where HIV infection and tuberculosis
are generally considered as a disease of social
inequities. The participants in our study are from
occupations which are relatively lowly paid, a large
number of them are migrants, and the use of
intoxicants is very high. A similar finding is seen in
studies done in other parts of the world, especially
South Asian nations and African countries. [20] A vast
majority (76%) of the participants reported exposure
to commercial sex workers and this may be the
reason behind the baseline demographic correlates
being skewed in favour of young males. This finding
is also in concordance with the results of similar
studies from other parts of the country which states
that commercial sex is the primary mode of HIV
infection for males and sexual relations with the
infected husband is the most important mode of
acquiring infection for females. [21]
In our study, the most common site of extrapulmonary tuberculosis infection was lymph nodes,
followed by pleura and abdomen. Tubercular
lymphadenitis was seen commonly in disseminated
tuberculosis infection as well as in isolated extrapulmonary tuberculosis. This finding is quite
different from the findings in other parts of the
country which stated that infection of the abdomen
and Central Nervous System were the most common
extra-pulmonary sites in HIV/TB co infection. The
proportion of disseminated tuberculosis cases among
all the extra-pulmonary tuberculosis patients was as
high as 50%, and this is much higher when compared
to data from other parts of the world. [22] This may be
due to the late diagnosis of tuberculosis and HIV
infection, Orissa being a relatively backward state in
socio-economic progress and healthcare delivery
indicators.
CONCLUSION
This study points towards the need to do more
extensive research in HIV/TB co-infection. All the
stakeholders of the Revised National Tuberculosis
Control Programme (RNTCP) and the National Aids
Control Programme (NACP) needs to be sensitised
on the need to screen for the other infection when one
of it is diagnosed in a patient. Since the diagnosis of
extra-pulmonary tuberculosis is difficult and
575
Ninan et al.,
10.
11.
ACKNOWLEDGEMENT
The authors would like to thank the patients and staff
of SCB Medical College and Hospital, Cuttack for all
their cooperation and help.
12.
13.
14.
15.
16.
17.
18.
19.
20.
Ninan et al.,
Southern
Africa.
PLoS
One.
2015;
10(3):0121775.
21. Bishnu S, Bandyopadhyay D, Samui S, Das I,
Mondal P, Ghosh P, Roy D, Manna S.
Assessment of clinico-immunological profile of
newly diagnosed HIV patients presenting to a
teaching hospital of eastern India. Indian J Med
Res. 2014; 139(6):903-12.
22. Sterling TR, Pham PA, Chaisson RE. HIV
infection-related
tuberculosis:
clinical
manifestations and treatment. Clin Infect Dis.
2010; 50 3:223-30.
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Ninan et al.,