Mustapha, Y
Department of Biological Sciences,Bayero University PMB 3011,Kano Nigeria

Abstract:

Background: A prospective study to assess the outcome of the directly observed treatment short course (DOTS) in tuberculosis patients with HIV co – infection was conducted in Kano, Nigeria between 2005 and 2006.

Methods: The study group included one thousand six hundred and ninety two Tuberculosis   patients (1066 men and 626 women) aged 15years and above. The recruitment protocol involved patients clinically diagnosed by X – ray and Mantoux test but with no previous tuberculosis treatment whose initial sputum demonstrated acid fast bacilli (AFB) on at least two occasions as confirmed by Ziehl Neelsen techniques and microscopical procedures. HIV serostatus was confirmed using HIV-1/HIV-2 ELISA Capillus, Geni-II HIV1/HIV2 kit and Determine HIV1/2 protocols. Standardized treatment regimen containing isoniazid, rifampicin, pyrazinamide and ethambutol were administered to the in patients for two months as intensive phase under the researchers’ direct clinical observation and monitoring. Treatment and follow up continued to the eighth month while the outcome of cure, were assessed using standard protocols.

Results: A total of six hundred and fifty (38.4%) sputum smear acid fast bacilli (AFB) positive patients(391 male and 259 female) were found to be sero positive for HIV. Treatment success rates after completion of dose regimen was 40% (261), of which 91% were sputum negative for AFB after the first treatment phase of two months. This increased to 94% and 97% by the 5th and 8th month respectively.

Conclusion: An incidence of 38.4% of HIV/TB co-infection was reported at the Kano State Government officially designated Infectious Disease Hospital (IDH) Kano (2005 – 2006). However, chemotherapy by DOTS was able to cure only 40% of patients, indicating efficacy much lower than the 85% targeted by the World Health Organization(WHO). Thus, new regimens and administration protocols are needed.

Keywords: Tuberculosis / HIV Co – infection, chemotherapy DOTS, Nigeria