PREVALENCE OF MICROBACTERIUM TUBERCULOSIS AND HIV CO-INFECTION AMONG PATIENTS ATTENDING DUTSE GENERAL HOSPITAL, JIGAWA STATE

CHAPTER ONE

1.1 Introduction

Tuberculosis is a defining opportunistic infection in a patient infected with the Human Immunodeficiency Virus (HIV). HIV increases the likelihood of reactivation and re-infection of Mycobacterium Tuberculosis (TB) among people living with HIV/AIDS (PLWHA) (Datiko et al., 2018). It has been documented that the burden of TB infection has increased since the occurrence of HIV infection (WHO, 2014). TB and HIV co-infection are increasing worldwide, but especially in developing countries. In Sub-Saharan Africa the co-infection rate is as high as 50 – 70%. South Africa, for instance, had a co-infection rate of 73% in 2007 (Kigozi et al., 2010). In countries like Australia, TB/HIV co-infection is not considered a major problem, since only eleven HIV/TB patients were identified in 2006. The National TB notification system recorded only 35.2% of TB patients co-infected with HIV (Bastian and Krause, 2017).

The dual epidemics of TB and HIV co-infection have raised the need for the implementation of collaborative TB/HIV programs, in order to reduce the burden of TB among PLWHA and the burden of HIV among people with TB. The problem is further compounded by the fact that TB is a leading cause of morbidity and mortality among people living with HIV (Sharma, Mohan and Kadhiravan, 2015; Nunn, Reid and Decock, 2017).

Therefore, knowing the HIV status of a TB/HIV patient is very important and is considered as an entry point for the comprehensive treatment/care of a TB patient co-infected with HIV. Efforts should, therefore, focus on increasing TB patients’ awareness or knowledge of the association between TB and HIV, so that patients can make informed decisions on the uptake of voluntary counseling and HIV Testing (VCT). Patients should be offered counseling on safer sex by the use of condoms, and they should benefit from the total care offered to TB patients co-infected with HIV, such as, isoniazid Preventive Therapy (IPT), Cotrimoxazole Preventive Therapy (CPT) and Antiretroviral Therapy (ART). Patients should also be counseled on how to live positively.

1.2 Statement of the Problem

It has been widely documented that the incidence of TB/HIV is increasing in countries with high HIV prevalence and that TB is the leading cause of death among HIV infected individuals in sub- Saharan Africa and Asia (WHO, 2017). In addition, the co-infection, coupled with patients behavioral factors are leading to the emergence of severe and resistant forms of TB (Mangesho et al, 2017).

The uptake of VCT(voluntary counseling testing) by TB/HIV patients is 71% in Nigeria, but WHO and the Nigerian national TB guidelines recommend that VCT must be offered to each and every TB patient to achieve 100% uptake (MOHSS, 2010). It is very important for a TB patient to know his/her HIV status because of the close association between TB and HIV. This enables patients to also benefit from total HIV care in case of co-infection. These drew the attention of the researcher to make deep investigation in order to explore the incidence of tuberculosis co-infection among HIV positive patients attending Dutse General Hospital Jigawa State.

1.3 Justification for the study

The incidence of mycobacterium tuberculosis co-infection with HIV continue to be a serious impediment to public health, to social and economic progress in most African countries. The researcher’s assumption is that if the TB patient knows the relationship and the incidence between TB and HIV, and knows his/her HIV status such a patient can change to less risky behavior or daily practices if HIV negative. If they are HIV positive the patient would decide on the next step in accessing care and support. This information would also permit the healthcare provider to maximize the management of both infections. However, in order to identify the factors that could contribute to high rates of TB-HIV co-infection it is imperative to assess the knowledge, attitude and practices of TB patients regarding HIV co-infection. This could shed more light on which strategies or interventions are patient centered for TB and HIV program implementers in Dutse General Hospital. The results of such an assessment would also help policy makers and healthcare providers develop strategies tailored to curtailing the high co-infection rate and improve TB and HIV treatment outcomes. Finally, this study will provide baseline data regarding incidence of TB-HIV co-infection.

1.4 Aim and Objectives of the Study

The aim of the researcher is to determine the prevalence of mycobacterium tuberculosis and HIV co-infection among HIV positive patients attending Dutse General Hospital.

Objectives

3        To determine the prevalence of mycobacterium tuberculosis and HIV co-infection among HIV positive patients based on their location

4        To determine the prevalence of mycobacterium tuberculosis and HIV co-infection among HIV positive patients based on their gender

5        To assess the level of knowledge and attitudes among mycobacterium tuberculosis and HIV co-infection patients

1.5 Research Hypotheses

1.      There is no relationship between the tuberculosis and Hiv positive patient attending Dutse General Hospital Jigawa State.

2.      There is a relationship between the tuberculosis and Hiv positive patient attending Dutse General Hospital Jigawa State

1.6 Significance of the Study

The impact of this research work in educational system cannot be over emphasized if is carefully conducted the information would permit the healthcare provider to maximize the management of both infections. However, in order to identify the factors that could contribute to high rates of TB-HIV co-infection it is imperative to assess the knowledge, attitude and practices of TB patients regarding HIV co-infection. This could shed more light on which strategies or interventions are patient centered for TB and HIV program implementers in Dutse General Hospital Jigawa State. The results of such an assessment would also help policy makers and healthcare providers develop strategies tailored to curtailing the high co-infection rate and improve TB and HIV treatment outcomes. Finally, this study will provide baseline data regarding incidence of TB-HIV co-infection.

1.7 Scope and Delimitation of the Study

Scope and delimitation are essential components of a research study that help define the boundaries and limitations of the investigation. In the context of the prevalence of Mycobacterium tuberculosis and HIV co-infection among patients attending Dutse General Hospital in Jigawa State, the scope and delimitation could be outlined as follows:

The study was focus specifically on patients attending a Dutse General Hospital in Jigawa State, Nigeria. The geographical boundaries will be limited to this particular region; The study was target patients who are attending the Dutse General Hospital in Jigawa State; The inclusion criteria may specify a particular age range, gender, or other relevant factors; The research was conducted within a specific time frame. For instance, the study may cover a certain number of months or years, and data collection was limited to this period; and The research was utilized specific methods for data collection, such as medical records review, laboratory tests, and interviews with patients. The scope was delineated the techniques employed to gather information.

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