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Two-year incidence of tuberculosis in cohorts of HIV-infected and uninfected urban Rwandan women.

Abstract
To determine the prevalence of Mycobacterium tuberculosis infection and the incidence of tuberculosis in HIV-infected and uninfected urban Rwandan women, 460 HIV-positive and 998 HIV-negative childbearing women were recruited from pediatric and prenatal care clinics and were enrolled in a prospective study in 1988 and followed for 2 yr. Tuberculin testing was administered 12 to 18 months after enrollment. Fifty-three percent of HIV-negative women had positive tuberculin tests (induration > or = 10 mm), with higher rates among older women and among women who had received BCG vaccine. Only 21% of HIV-positive women had positive tuberculin tests, with no relationship to BCG vaccine. Follow-up was available for 93% of subjects. Tuberculosis was diagnosed in 20 HIV-positive women and in two HIV-negative women. Features associated with an increased risk of tuberculosis among HIV-positive women included: age > or = 30, body mass index in the lowest quartile, low income, erythrocyte sedimentation rate > 75, positive tuberculin test, and chronic cough, chronic fever, and weight loss. Among Rwandan women who are infected with HIV, approximately half of those who are infected with M. tuberculosis do not have positive tuberculin tests. The rate ratio for development of tuberculosis among HIV-positive women was 22 (95% CI, 5 to 92). New algorithms are needed to improve the early detection of tuberculosis among HIV-positive patients in Africa.
AuthorsS Allen, J Batungwanayo, K Kerlikowske, A R Lifson, W Wolf, R Granich, H Taelman, P Van de Perre, A Serufilira, J Bogaerts
JournalThe American review of respiratory disease (Am Rev Respir Dis) Vol. 146 Issue 6 Pg. 1439-44 (Dec 1992) ISSN: 0003-0805 [Print] United States
PMID1456559 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, P.H.S.)
Chemical References
  • BCG Vaccine
Topics
  • AIDS Serodiagnosis
  • Adolescent
  • Adult
  • BCG Vaccine
  • Female
  • Follow-Up Studies
  • HIV Infections (complications)
  • Humans
  • Incidence
  • Prospective Studies
  • Rwanda (epidemiology)
  • Tuberculin Test
  • Tuberculosis, Pulmonary (complications, diagnosis, epidemiology, prevention & control)

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