Tuberculosis With Malaria or HIV Co-Infection in a Large Hospital in Luanda, Angola

J Infect Dev Ctries. 2013 Mar 14;7(3):269-72. doi: 10.3855/jidc.2703.

Abstract

Introduction: Three major public health problems, tuberculosis, malaria and HIV/AIDS, are widespread in Angola, often as co-infections in the same individual. In 2009, it was assumed that 44,151 new cases of TB occurred in Angola. Interestingly, interventions such as treatment/prevention of malaria appear to reduce mortality in HIV-infected and possibly TB co-infected patients. However, despite the seriousness of the situation, current data on TB and co-infection rates are scarce. This study aimed to characterize all TB cases seen at the Hospital Sanatório de Luanda, and to determine the co-infection rate with HIV and/or malaria.

Methodology: This retrospective study collected demographic, diagnostic and clinical data from all patients admitted during 2007.

Results: A total of 4,666 patients were admitted, of whom 1,906 (40.8%) were diagnosed with TB. Overall, 1,111 patients (58.3%) were male and most patients (n=1302, 68.3%) were adults (≥ 14 years). The rate of HIV co-infection was 37.4% (n=712). Malaria was diagnosed during admission and hospital stay in 714 patients (37.5%), with Plasmodium falciparum the predominant species. Overall mortality was 15.2% (n=290).

Conclusions: Because Luanda does not have the infrastructure to perform culture-based diagnosis of TB, confirmation of TB is problematic. The HIV-co-infection rate is high, with 37.4% of patients requiring integrated approaches to address this problem. With more than 1/3 of the TB patients co-infected with malaria, even during the hospital stay, the prevention of malaria in TB patients appears to be an effective way to reduce overall mortality.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Angola / epidemiology
  • Child
  • Child, Preschool
  • Coinfection / epidemiology*
  • Female
  • HIV Infections / complications*
  • HIV Infections / epidemiology*
  • Hospitals
  • Humans
  • Infant
  • Malaria, Falciparum / complications*
  • Malaria, Falciparum / epidemiology*
  • Male
  • Middle Aged
  • Prevalence
  • Retrospective Studies
  • Tuberculosis / complications*
  • Tuberculosis / epidemiology*
  • Young Adult