Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Jan 28;17(1):e0262720.
doi: 10.1371/journal.pone.0262720. eCollection 2022.

Prevalence and associated risk factors for tuberculosis among people living with HIV in Nepal

Nilaramba Adhikari  1 , Ratna Bahadur Bhattarai  2 , Rajendra Basnet  2 , Lok Raj Joshi  2 , Bhim Singh Tinkari  3 , Anil Thapa  3 , Basant Joshi  4
Affiliations

Prevalence and associated risk factors for tuberculosis among people living with HIV in Nepal

Nilaramba Adhikari et al. PLoS One. .

Abstract

Background: Worldwide tuberculosis (TB) takes more lives than any other infectious diseases. WHO estimates around 68,000 incident TB cases in Nepal. However, in 2018 only around 27,232 new TB cases were reported in the national system, resulting around 40,768 incident TB cases missing every year in Nepal. National Tuberculosis Control Center carried out this study in anti-retroviral therapy (ART) sites to estimate the prevalence of TB and identify the associated risk factors for TB among the people living with Human Immunodeficiency Virus (PLHIVs) in Nepal.

Methods: It was a cross-sectional institution-based study conducted between March and August 2018. Six ART sites with high caseloads of PLHIVs were selected. PLHIVs who were equal or above 18 years of age and were in ART program at the selected study sites were considered eligible for the study. Diagnosis of tuberculosis among PLHIVs who agreed to participate in the study was carried out as per the National Tuberculosis Management Guideline of National Tuberculosis Program of Nepal.

Results: Among 403 PLHIVs, tuberculosis was diagnosed in 40 (9.9%) individuals. Median age of the participants was 36 (30-43) years. Prevalence of TB was significantly higher among male PLHIVs than female PLHIVs (13.6% Vs 5.8%; P = 0.02) and Dalit ethnic group compared to Brahmin/Chettri (22.0%Vs5.9%, P = 0.01). The risk of developing TB was found significant among those with HIV stage progressed to WHO stage 3 and 4 (OR = 4.85, P<0.001) and with the family history of TB (OR = 4.50, P = 0.002).

Conclusions: Prevalence of TB among PLHIVs in Nepal was found 9.9%. Risk of developing TB was higher among PLHIVs who were male, Dalit, with HIV stage progressed to WHO stage 3 and 4 and with family history of TB. Hence, targeted interventions are needed to prevent the risk of developing TB among PLHIVs. Similarly, integrated, and comprehensive TB and HIV diagnosis and treatment services are needed for the management of TB/HIV co-infection in Nepal.

PubMed Disclaimer

Conflict of interest statement

The authors have declared that no competing interests exist.

References

    1. World Health Organization. Global Tuberculosis Report 2020 [Internet]. 2020. Available from: https://apps.who.int/iris/bitstream/handle/10665/336069/9789240013131-en....
    1. Walzl G, McNerney R, du Plessis N, Bates M, McHugh TD, Chegou NN, et al.. Tuberculosis: advances and challenges in development of new diagnostics and biomarkers. Lancet Infect Dis [Internet]. 2018. Jul;18(7):e199–210. Available from: https://linkinghub.elsevier.com/retrieve/pii/S1473309918301117. doi: 10.1016/S1473-3099(18)30111-7 - DOI - PubMed
    1. Peters JS, Andrews JR, Hatherill M, Hermans S, Martinez L, Schurr E, et al.. Advances in the understanding of Mycobacterium tuberculosis transmission in HIV-endemic settings. Lancet Infect Dis. 2019;19(3):e65–76. doi: 10.1016/S1473-3099(18)30477-8 - DOI - PMC - PubMed
    1. Bruchfeld J, Correia-Neves M, Källenius G. Tuberculosis and HIV Coinfection. Cold Spring Harb Perspect Med [Internet]. 2015. Jul;5(7):a017871. Available from: http://perspectivesinmedicine.cshlp.org/lookup/doi/10.1101/cshperspect.a.... - DOI - PMC - PubMed
    1. Kyu HH, Maddison ER, Henry NJ, Ledesma JR, Wiens KE, Reiner R, et al.. Global, regional, and national burden of tuberculosis, 1990–2016: Results from the Global Burden of Diseases, Injuries, and Risk Factors 2016 Study. Lancet Infect Dis. 2018;18(12):1329–49. doi: 10.1016/S1473-3099(18)30625-X - DOI - PMC - PubMed

Publication types

MeSH terms