dc.contributor.author | Gilks, CF | |
dc.contributor.author | Godfrey-Faussett, P | |
dc.contributor.author | Batchelor, BI | |
dc.contributor.author | Ojoo, JC | |
dc.contributor.author | Ojoo, SJ | |
dc.contributor.author | Brindle, RJ | |
dc.contributor.author | Paul, J | |
dc.contributor.author | Kimari, J | |
dc.contributor.author | Bruce, MC | |
dc.contributor.author | Bwayo, J | |
dc.contributor.author | Plummer, FA | |
dc.contributor.author | Warrell, DA | |
dc.date.accessioned | 2013-10-18T07:43:15Z | |
dc.date.available | 2013-10-18T07:43:15Z | |
dc.date.issued | 1997 | |
dc.identifier.uri | http://erepository.uonbi.ac.ke:8080/xmlui/handle/123456789/57694 | |
dc.identifier.uri | http://www.ncbi.nlm.nih.gov/pubmed/9189217 | |
dc.description | Journal Article | en |
dc.description.abstract | Abstract
OBJECTIVES:
To describe the epidemiological and clinical characteristics of HIV-related tuberculosis in a female cohort, and to investigate the relative importance of recently transmitted infection and reactivation in the pathogenesis of adult HIV-related tuberculosis.
DESIGN:
Members of an established cohort of female sex workers in Nairobi were enrolled in a prospective study. Women were followed up regularly and seen on demand when sick.
METHODS:
Between October 1989 and September 1992 we followed 587 HIV-infected and 132 HIV-seronegative women. Standard protocols were used to investigate common presentations. Cases of tuberculosis were identified clinically or by culture. All available Mycobacterium tuberculosis strains underwent DNA fingerprint analysis.
RESULTS:
Forty-nine incident and four recurrent episodes of tuberculosis were seen in HIV-infected women; no disease was seen in seronegative sex workers (P = 0.0003). The overall incidence rate of tuberculosis was 34.5 per 1000 person-years amongst HIV-infected participants. In purified protein derivative (PPD) skin test-positive women the rate was 66.7 per 1000 person-years versus 18.1 per 1000 person-years in PPD-negative women. Twenty incident cases (41%) were clinically compatible with primary disease. DNA fingerprint analysis of strains from 32 incident cases identified two clusters comprising two and nine patients; allowing for index cases, 10 patients (28%) may have had recently transmitted disease. Three out of 10 (30%) patients who were initially PPD skin test-negative became PPD-positive. Taken together, 26 incident cases (53%) may have been recently infected. DNA fingerprint analysis also identified two (50%) of the four recurrent tuberculosis episodes as reinfection.
CONCLUSIONS:
Substantial recent transmission of tuberculosis appears to be occurring in Nairobi amongst HIV-infected sex workers. It may be incorrect to assume in other regions of high tuberculosis transmission that active HIV-related tuberculosis usually represents reactivation of latent infection. | en |
dc.language.iso | en | en |
dc.publisher | University of Nairobi | en |
dc.title | Recent transmission of tuberculosis in a cohort of HIV-1-infected female sex workers in Nairobi, Kenya. | en |
dc.type | Article | en |
local.publisher | c | en |