Improving Surveillance on Tuberculosis and HIV Co-Infection inKazakhstan

In Kazakhstan, tuberculosis (TB) patients are screened for human immunodeficiency virus (HIV), and HIV- infected individuals are screened for active TB. However, there is no exchange of case-based information between the TB and HIV/AIDS programs. To assess the proportion of co-infected patients registered as such in both registers and to assess reasons for patients missing in either register, we compared 2009 data from the TB and HIV/AIDS registers from two areas in Kazakhstan. Almaty city and the adjacent Almaty oblast, represent 22% of the country's population. Also, co-infected patients as well as a number of HIV-infected individuals were interviewed. In total, 85 patients diagnosed with TB and HIV were registered, of whom 73 were registered in the TB register, 79 in the HIV/AIDS register, and 67 in both registers. In the TB register, twelve patients were wrongly recorded as HIV negative. Only 9 (11%) out of the 82 patients who started treatment (three died shortly after diagnosis) had been prescribed antiretroviral treatment. In conclusion, gaps and mistakes with regard to TB/HIV patients were identified in both registers. Collaboration between the TB and HIV/AIDS centers was strengthened, which includes routine monitoring of TB/HIV diagnoses and treatment. This should lead to improved quality of care for TB/HIV patients and an improved insight in TB/HIV epidemiology.