ABSTRACT
BACKGROUND: Drug resistance among tuberculosis patients in sub-Saharan Africa is increasing, possibly due to association with HIV infection. We studied drug resistance and HIV infection in a representative sample of 533 smear-positive tuberculosis patients diagnosed in Kampala, Uganda. METHODS/PRINCIPAL FINDINGS: Among 473 new patients, multidrug resistance was found in 5 (1.1%, 95% CI 0.3-2.5) and resistance to any drug in 57 (12.1%, 9.3-15.3). Among 60 previously treated patients this was 7 (11.7%, 4.8-22.6) and 17 (28.3%; 17.5-41.4), respectively. Of 517 patients with HIV results, 165 (31.9%, 27.9-36.1) tested positive. Neither multidrug (adjusted odds ratio (OR(adj)) 0.7; 95% CI 0.19-2.6) nor any resistance (OR(adj) 0.7; 0.43-1.3) was associated with HIV status. Primary resistance to any drug was more common among patients who had worked in health care (OR(adj) 3.5; 1.0-12.0). CONCLUSION/SIGNIFICANCE: Anti-tuberculosis drug resistance rates in Kampala are low and not associated with HIV infection, but may be associated with exposure during health care.
Subject(s)
HIV Infections/epidemiology , Tuberculosis, Multidrug-Resistant/epidemiology , Antitubercular Agents/pharmacology , HIV Infections/complications , Health Personnel , Humans , Incidence , Tuberculosis, Multidrug-Resistant/complications , Tuberculosis, Multidrug-Resistant/transmission , Uganda/epidemiologyABSTRACT
A restrospective investigation of mortality among Uganda's highly trained manpower was carried out in 1990. It was found that the mortality rate in this category had increased from 0.4per year during the pre-AIDS period to 2.5per year by 1990. This increase was largely attributable to AIDS. These findings show that AIDS is causing big losses in training investment in Uganda
