TB/HIV CO INFECTION

Presented by:
Asmita Thapa(08)
Nirmala Bista (21)
Samjhana Shrestha(31)
Seema Giri(32)
Sweta Pathak(38)
 INTRODUCTION
• Tuberculosis (TB) is an infectious bacterial disease
caused by the tubercle bacilli, Mycobacterium
Tuberculosis. It has become a major public health
concern worldwide as one third of the world’s population
is infected with the disease TB

• Acquired Immune Deficiency Syndrome (AIDS), a fatal

disease state caused by Human Immuno- deficiency
Virus (HIV-1&2),have become frighteningly familiar
words across the globe, conjuring up feelings of
suffering and death
 Contd…
• HIV and TB have been described as the “Diabolical
Duet". The reason is that the two go together. When
someone is infected with HIV, the virus weakness their
immune system usually helps to fight off diseases, so
they are now more susceptible to infections.

• A person with HIV is up to 30 times more likely to

develop active clinical TB than a person with a healthy
immune system.
 Contd….
• The number of people co- infected with TB and HIV –
already stands at over 10 million and is expected to
increase dramatically over the next 10 years.

• The World Health Organization (WHO) estimates 11.4

million people are infected with both Mycobacterium
tuberculosis and HIV in the world. The primary cause of
death in those infected with HIV is from TB, not AIDS.
 Contd…
• In South East Asia Region the increasing incidence of
HIV/AIDS may fuel the TB epidemic, which is the
second hardest hit by the HIV-epidemic.

• The incidence of both diseases is highest in the

economically productive age groups (15-54 years),
poses significant threats not only to health, but also to
the social and economic development.
STATEMENT OF PROBLEM
Contd..
• TB is the most common presentation of AIDS
in HIV infected persons—the so-called
“mother of AIDS.” The marriage of these two
deadly infections creates huge challenges for
patients, communities, and health systems.
• People living with HIV are 6 times more likely
to die during TB treatment
• 1.4 million (15%) TB cases occur in people
living with HIV and 0.5 million TB deaths in
people living with HIV.
PURPOSE OF THE STUDY
• General Objective;
To study the status of HIV/TB co-infection.

• Specific Objective;
1. To assess the total number of TB and HIV
cases in Nepal and SAARC.
2. To assess the status of HIV/TB co-infection
in Nepal and SAARC.
3. To compare the status of HIV/TB co-
infection in SAARC Region and in Nepal.
 METHODOLODY

• Variables of the study: Age and Sex.

• Study area: The study was conducted in

Nepal.
.
• Study duration; The study was done from mid
May to June.

• Study design; The study is cross sectional

descriptive type of study.
 Contd..
• Data collection procedure; Secondary sources were
used. (SAARC TB and HIV/AIDS Centre)

• Data processing and Analysis: The data was managed

and analyzed in MS-Excel.

• Limitations of the Study: HIV/TB co- infection, though has

affected almost all the segments of the world it is still a new
chapter in the context of Nepal. So, adequate secondary
sources of data are not available. Besides, the study is
solely based on secondary data.
 FINDINGS
Figure 1 Showing number of HIV cases by gender
distribution in Nepal
Number of HIV cases

9000
8000 7646

7000
6000
5000
4000 3588

3000
2000
1000
0
Male Female

Source: NCASC, Teku, Kathmandu

Contd..
Figure 2 showing Gender distribution among
different types of TB cases

Source: Annual Report, 2009

Contd..
• Figure 3 showing the estimates of TB disease
prevalence in SAARC Region

Source: Global TB Control 2009, WHO

 Contd…
• Figure 4 showing the estimated percentage of
people living with HIV in SAARC Region

Source: HIV and AIDS in SAARC Region, an update 2008

Contd..
• Figure 5 showing HIV prevalence in incident TB
cases in SAARC countries,2006

Source: Global TB Control 2009, WHO

Contd..
• Figure 6 showing HIV prevalence among TB
patients in Nepal

S o u rc e : A n n u a l R e p o
 DISSCUSSION
• At present the dual intersecting infections (HIV/TB) have
threatened the lives of many people around the globe and have
now emerged as a global public health problem.
• 1.4 million (15%) TB cases occur in people living with HIV and
0.5 million TB deaths in people living with HIV.
• However, there is no official data on the magnitude of the TB/HIV
co-infection in Nepal and also SAARC countries.
• According to the findings of the study,HIV prevalence among TB
patients is increasingly continuously from 1993/94 to 2006/2007
in Nepal. It was 0.00% in 1993/94 which increased to 2.40% in
2006/2007. However, the HIV prevalence among TB patient
seems to be constant in 2001/02 to 2006/07
 Contd..
• According to the findings of the study, HIV prevalence
among TB patients is increasingly continuously from
1993/94 to 2006/2007 in Nepal. It was 0.00% in 1993/94
which increased to 2.40% in 2006/2007. However, the HIV
prevalence among TB patient seems to be constant in
2001/02 to 2006/07
• Maldives among SAARC countries has the highest HIV
prevalence in incident TB cases in the year 2006 which is
2%. However, the current data couldn’t be retrieved.
 Conclusion
• The unparallel magnitude of the HIV/AIDS and TB
epidemic remain major public health challenges globally.

• Moreover the dual intersecting infection (TB/HIV) presents

global public health with additional fears and particularly
so within the developing countries e.g. SAARC countries.

• People who are HIV positive and infected with TB are 30

times more likely to develop active TB than people who
are HIV negative
 Contd..
• The prevalence of TB/HIV co infection is in increasing in
developing countries particularly in SAARC regions.

• The dual combination of TB and HIV is very lethal and

thus has contributed to rapid rising TB/HIV co infection
prevalence in developing region.
RECOMMENDATION

1. Offer systematic and regular TB screening to

HIV-infected patients in SAARC region.

2. Extend TB screening among the families of HIV

infected patients.

3. Introduction of tools that collect information on

both TB and HIV in all developing countries.
Contd..

4. Advocacy and planning in the awareness

about TB/HIV co infection.

5. National policy of counseling and testing

TB patients for HIV and National
Surveillance system of HIV infection in TB
patients should be adopted in all SAARC
countries.
References

1. Situation Analysis of TB, HIV/AIDS and TB/HIV

Co-infection in the SAARC Region

2. TB/HIV Co-epidemic in the SAARC Region

3. HIV & AIDS in the SAARC Region: An Update

2008

4. Tuberculosis Control SAARC Region Update-

2009
 Contd..
5. Powerpoint Presentation on TB/HIV infection: the
cursed duet by Sanjay Bhagani
6. Powerpoint Presenataion on Management of TB/HIV
co-infection:
Challenges and Perspectives by Marco Vitoria,
WHO, HIV Department, Geneva, August 2009
7. TB-HIV co-infection in India,Vaidyanathan PS &
Sanjay S: NTI Bulletin 2003, 39/ 3 & 4, 11 – 18