Prevalence of Non-Tuberculosis Mycobacterium Pulmonary Disease in HIV-1 Patients with Presumptive Pulmonary Tuberculosis in Western Kenya

IF 1.5 Q3 HEALTH CARE SCIENCES & SERVICES Ethiopian Journal of Health Sciences Pub Date : 2023-09-21 DOI:10.4314/ejhs.v33i5.3
Anne Ochayo, Ronald Wamalwa, Erick Barasa, Jeremiah Zablon, George Sowayi, Tom Were, Godfrey Gitonga, Nathan Shaviya
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Abstract

Background: Non-tuberculous mycobacteria (NTMs) are ubiquitous, free-living, environmental saprophytic microorganisms. NTMs belong to the genus Mycobacterium which includes Mycobacterium tuberculosis (MTB). NTMs have lately been a major cause of pulmonary disease (PD) in immuno-compromised individuals including HIV-1 patients. NTMs and MTB appear similar based on microscopy, radiology, and clinical symptoms; consequently, this may lead to misdiagnosis. This study sought to establish the prevalence of NTM pulmonary disease in HIV-1 patients presumed to have pulmonary tuberculosis. Methods: A cross-sectional analytical laboratory study design was used targeting 617 adult HIV-1 infected patients presenting with presumptive pulmonary TB at Bungoma County Hospital Comprehensive Care Clinic in Western Kenya between July 2021 to June 2022. Results: A total of 75 (12.2%, 4.6 -9.8 CI) of the participants presented with presumptive MTB and had TB-like symptoms while 542 (87.8%, 12.5 -30.7 CI) were negative. Additionally, 56 (9.1%) were infected with NTMs. HIV-positive participants had a significantly higher prevalence of NTMs 62 (11.8%, 5.6 -9.2 CI) compared to 2 (2.1%, 0.4 -1.8 CI). In HI 10 (13.3%) as well as M. kansasii 8 (10.7%). V + study participants P<0.0001. M. avium was the most prevalent NTM, 25(33.3%), followed by M. fortuitum 20 (26.7%). A significant number of the isolates were M. tuberculosis Conclusion: There seems to be a high prevalence of NTMPD in HIV-1 patients which is assumed to be pulmonary TB. Differential diagnosis of the mycobacterium species is necessary to help improve disease management and outcomes in this group of patients.
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肯尼亚西部推定肺结核的HIV-1患者中非结核分枝杆菌肺病的患病率
背景:非结核分枝杆菌(ntm)是普遍存在的、自由生活的环境腐生微生物。ntm属于分枝杆菌属,其中包括结核分枝杆菌(MTB)。ntm最近已成为包括HIV-1患者在内的免疫受损个体肺部疾病(PD)的主要原因。根据显微镜、放射学和临床症状,ntm和MTB表现相似;因此,这可能导致误诊。本研究旨在确定假定患有肺结核的HIV-1患者中NTM肺病的患病率。方法:采用横断面分析实验室研究设计,针对2021年7月至2022年6月在肯尼亚西部邦戈马县医院综合护理诊所出现的617名成年HIV-1感染的推定肺结核患者。结果:共有75名(12.2%,4.6 -9.8 CI)参与者表现出假定MTB并有tb样症状,而542名(87.8%,12.5 -30.7 CI)参与者呈阴性。此外,56例(9.1%)感染ntm。hiv阳性参与者的ntm患病率明显高于2 (2.1%,0.4 -1.8 CI) (11.8%, 5.6 -9.2 CI)。在HI 10(13.3%)和M. kansasii 8(10.7%)。V +研究参与者P<0.0001。NTM中以鸟分枝杆菌(M. avium)最多,25只(33.3%),其次是福氏分枝杆菌(M. fortuitum) 20只(26.7%)。大量分离株为M. tuberculosis 结论:NTMPD在HIV-1患者中似乎有很高的患病率,这可能是肺结核。分支杆菌种类的鉴别诊断对于帮助改善这组患者的疾病管理和预后是必要的。
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来源期刊
Ethiopian Journal of Health Sciences
Ethiopian Journal of Health Sciences HEALTH CARE SCIENCES & SERVICES-
CiteScore
2.10
自引率
8.30%
发文量
137
审稿时长
12 weeks
期刊介绍: Ethiopian Journal of Health Sciences is a general health science journal addressing clinical medicine, public health and biomedical sciences. Rarely, it covers veterinary medicine
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