Tuberculosis with malaria or HIV co-infection in a large hospital in Luanda, Angola.

INTRODUCTION: Three major public health problems, tuberculosis, malaria and HIV/AIDS, are widespread in Angola, often as co-infections in the same individual. In 2009, it was assumed that 44,151 new cases of TB occurred in Angola. Interestingly, interventions such as treatment/prevention of malaria appear to reduce mortality in HIV-infected and possibly TB co-infected patients. However, despite the seriousness of the situation, current data on TB and co-infection rates are scarce. This study aimed to characterize all TB cases seen at the Hospital Sanatório de Luanda, and to determine the co-infection rate with HIV and/or malaria. METHODOLOGY: This retrospective study collected demographic, diagnostic and clinical data from all patients admitted during 2007. RESULTS: A total of 4,666 patients were admitted, of whom 1,906 (40.8%) were diagnosed with TB. Overall, 1,111 patients (58.3%) were male and most patients (n=1302, 68.3%) were adults (≥ 14 years). The rate of HIV co-infection was 37.4% (n=712). Malaria was diagnosed during admission and hospital stay in 714 patients (37.5%), with Plasmodium falciparum the predominant species. Overall mortality was 15.2% (n=290). CONCLUSIONS: Because Luanda does not have the infrastructure to perform culture-based diagnosis of TB, confirmation of TB is problematic. The HIV-co-infection rate is high, with 37.4% of patients requiring integrated approaches to address this problem. With more than 1/3 of the TB patients co-infected with malaria, even during the hospital stay, the prevention of malaria in TB patients appears to be an effective way to reduce overall mortality.

Tuberculosis with Malaria or HIV Co-Infection in a Large Hospital in Luanda; Angola

"Introduction: Three major public health problems; tuberculosis; malaria and HIV/AIDS; are widespread in Angola; often as co-infections in the same individual. In 2009; it was assumed that 44;151 new cases of TB occurred in Angola. Interestingly; interventions such as treatment/prevention of malaria appear to reduce mortality in HIV-infected and possibly TB co-infected patients. However; despite the seriousness of the situation; current data on TB and co-infection rates are scarce. This study aimed to characterize all TB cases seen at the Hospital Sanatorio de Luanda; and to determine the co-infection rate with HIV and/or malaria. Methodology: This retrospective study collected demographic; diagnostic and clinical data from all patients admitted during 2007. Results: A total of 4;666 patients were admitted; of whom 1;906 (40.8) were diagnosed with TB. Overall; 1;111 patients (58.3) were male and most patients (n=1302; 68.3) were adults (""d14 years). The rate of HIV co-infection was 37.4 (n=712). Malaria was diagnosed during admission and hospital stay in 714 patients (37.5); with Plasmodium falciparum the predominant species. Overall mortality was 15.2(n=290). Conclusions: Because Luanda does not have the infrastructure to perform culture-based diagnosis of TB; confirmation of TB is problematic. The HIV-co-infection rate is high; with 37.4 of patients requiring integrated approaches to address this problem. With more than 1/3 of the TB patients co-infected with malaria; even during the hospital stay; the prevention of malaria in TB patients appears to be an effective way to reduce overall mortality."