Tuberculosis (TB) Co-infection with HIV/AIDS: Clinical Presentation at Lacor Hospital, a Post-conflict Northern Uganda

Abstract

Aims: To characterize the various clinical presentations of TB diagnosed in HIV/AIDS patients in the post-conflict Northern Uganda. Study Design and Setting: A prospective cohort study was conducted on 320 TB/HIV/AIDS co-infected patients at St. Mary’s Hospital, Lacor which is a specialist hospital in Gulu, Northern Uganda from July 2009 to July 2010. Methodology: Clinical features of confirmed 320 HIV sero-positive patients with confirmed TB co-infection (170 males and 150 females) recruited consecutively were studied and followed up for three months, their clinical presentations analyzed using SPSS version13.0. Ethics and Review Committee approved the study and those who did not meet the inclusion criteria were excluded. All patients gave an informed consent/Assent for the study. Results: The commonest clinical presentations were fever 316(98.8%), productive cough 268(83.7%), evening/night sweats 267(83.4%), general malaise 277(86.6%), wasting 228(71.3%), anaemia 220(68.8%) and lymphadenopathy 100(31.3%). The clinical features which were associated statistically and significantly with TB/HIV/AIDS co-infection were: Low grade fever (p=0.006); haemoptysis (p=0.001); Night sweats and evening fevers (p=0.043); Chest pain (p=0.041); General malaise (p=0.037) and wasting (p=0.047). Most patients 262(81.9%) improved and were discharged on Directly Observed Therapy Short-course (DOTS) while 58(18.1%) died. Conclusion: Clinical assessment is a very important adjuvant in TB/HIV/AIDS co-epidemic diagnosis. Early diagnosis and prompt management of TB co-infection ensured longer life and reduced morbidity and mortality.