![]() ![]() Infection with HIV is one of the major risk factors for TB and more than half of TB patients live in countries ravaged by Human Immuno-Deficiency Virus/Acquired Immune Deficiency Syndrome (HIV/ AIDS). An estimated one-quarter of the world’s population is infected with Mycobacterium tuberculosis, with the highest prevalence of the disease found in sub-Saharan Africa and Asia. Tuberculosis (TB) is a major Public Health issue worldwide, particularly in low- and middle-income countries. This underscores the need to expand the facilities for culture and confirmation in TB centers across the country. There is also relatively high culture positivity among the patients. The study found cough, fever and anemia to be the commonest presentation in patient with SNPTB in a high HIV burden patient’s population. ![]() Of the 150 sputa sample analyzed, 21/150 (14.0%) and 22/150 (14.7%) where Gene Xpert and sputum culture positive respectively. Chest x rays were reported as typical of TB in only 24 (16%) of the patients. ![]() About 87 (58%) had fever and 110 (73.7%) had anemia, while weight loss and night sweat were reported in 98(65.3%) and 82 (54.7%) of the patients respectively. All the patients had a history of cough for over a period of at least three weeks, while, 27 (18%) reported having hemoptysis. History of cigarette smoking was obtained in only 7(4.7%) of the patients while 82 (64.1%) were HIV positive. Twenty-two (14.7%) of the patients had previous TB treatment. The median age of the patients was 36.5 years with greater percentage of the patients within the ages of 25–44 years 92 (61.3%). Majority of the patients were female 93 (62%). A total of 150 patients with SNPTB were studied. The Xpert MTB/RIF tests and sputum culture (using LJ medium) were done in a TB reference laboratory. Also, the base line Chest X-ray films taken during TB screening were reviewed and reported by two radiologists blinded to each other’s reports. Baseline results of packed cell volume, HIV test and sputum acid fast bacilli done during TB screening were retrieved from the patients’ case notes and recorded. Detailed clinical examination was also done on all the study subjects. Demographic data (sex, age), smoking status, and medical history (clinical form of TB, symptoms at admission, diagnostic methods, presence of comorbidities, prior TB treatment) were obtained using a semi-structured questionnaire. All patients 18 years and above who were newly diagnosed as SNPTB, or patients with SNPTB who had not taken TB drugs for up to 2 weeks irrespective of their HIV status were recruited. The study was a cross-sectional study among patients with SNPTB in four major hospitals that care for TB/HIV patients in north-central Nigeria. We evaluated the epidemiology and clinical presentation of SNPTB in a cohort of patients with high HIV burden. Most of these countries have challenges in diagnosis and treatment of TB in people with smear-negative pulmonary tuberculosis (SNPTB), which remains a significant public health challenge because of the global burden of the disease. Tuberculosis (TB) is a serious disease of public health concern, mainly in low- and middle-income countries.
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