Time series cross-correlation analysis of HIV seropositivity and pulmonary tuberculosis among migrants entering Kuwait

There is a paucity of published data on burden and pattern of dual infection with Mycobacterium tuberculosis and HIV among migrants from South Asia, South-east Asia and sub-Saharan Africa entering the Middle-East, particularly Kuwait. Therefore, this study assessed the overall prevalence of HIV infection and pulmonary tuberculosis [TB] and evaluated the ecological relationship between them. Time series cross-correlation analysis was used to determine the ecological time-lagged relationship between the monthly proportions [per 100,000] of HIV seropositive and pulmonary TB cases among migrant workers that entered Kuwait between January 1, 1997 and December 31, 2006. During the study period, overall prevalence [per 100,000] of HIV seropositivity and pulmonary TB among the migrants was 21 [494/23,28,582] [95% CI: 19-23], and 198 [4608/23,28,582] [95% CI: 192-204], respectively. Estimated cross-correlation function revealed a significant positive correlation [0.292 +/- 0.093] at lag -3 representing a positive relationship between the proportions of HIV seropositive [per 100,000] migrants tested 3 months earlier and the proportion of pulmonary TB [per 100,000] cases detected among migrants in a given month. Thus, the peak in proportion of pulmonary TB cases preceded the peak in proportion of HIV seropositive migrants indicating a direct time-lagged association between HIV seropositivity and the prevalence of pulmonary TB among migrants. HIV infection seemed to have played a significant role in the re-activation of latent M. tuberculosis infection in this migrant population. While currently less evident, in near future, however, TB and HIV/AIDS control programmes in the countries of origin of migrants may face a crucial challenge. Knowledge of serious consequences of association between HIV infection and pulmonary TB allows the promotion of public heath education to reduce the exposure to these infections. Future studies may focus on evaluating the impact of public health education programs on this dual burden of HIV infection and pulmonary TB in migrants

Infectious diseases detected among immigrants in Kuwait

The aim of this study was to detect the infectious diseases prevalent among immigrants and to control their spread in Kuwait. More than 200,000 immigrants come to Kuwait every year for residence or work, and the majority of them [75%] come from developing countries w h e re infectious diseases are endemic. All the immigrants were checked for infectious diseases like, malaria, filaria, tuberculosis, HIV and hepatitis B and C before they were issued a residence permit. These tests were performed between 1991 and 1999. The screened population consisted of 921,012 for malaria and filaria; 1,645,052 for HIV; 326,246 for hepatitis B and C and 1,645,052 for tuberculosis. The total number of persons infected with all the five diseases was 11,545 [0.2%]. About 1366 [0.15%] individuals were infected with malaria; 691 [0.08%] with filaria; 591 [0.04%] with HIV; 1194 [0.4%] with hepatitis B; 628 [0.2%] with hepatitis C and 7075 [0.4%] with tuberculosis. All the newly arrived immigrants infected with malaria were treated in the Infectious Diseases Hospital, Kuwait. Those with filaria, HIV, hepatitis B and C were deported to their country of origin because of the risk of transmission of these