Tuberculosis and AIDS co-morbidity in Brazil: linkage of the tuberculosis and AIDS databases

ABSTRACT

This study evaluated differences in AIDS patients with and without tuberculosis (TB) in Espírito Santo State, Brazil. Standard regional AIDS (SINAN, SISCEL, SICLOM and SIM) and tuberculosis (SINAN) databases were used. TB and AIDS databases were linked using Reclink software, version 3, with SPSS software support to identify co-infected cases. Data from July 2000 to June 2006 in Espírito Santo State were linked. The results showed 3,523 adult AIDS cases and 9,958 adult TB cases resulted in 430 co-infected patients, who were compared to 1,290 AIDS patients who never developed TB. Among 430 co-infected patients, TB was diagnosed first in 223 (51.9 percent), AIDS was first in 44 (10.2 percent), and AIDS and TB were diagnosed concurrently in 163 (37.9 percent). Median age did not differ between co-infected cases (36 years (interquartile range [IQR] 29-43) and non-co-infected cases (34 years; IQR 28-42). Pulmonary tuberculosis was diagnosed in 239 (55.6 percent); 109 (25.3 percent) had extra-pulmonary TB and 82 (19.1 percent) had both presentations. In the final logistic regression model, living in a metropolitan area [Odds Ratio (OR)=1.43 (95 percent Confidence Interval (CI) 1.05-1.95)], education < 3 years [OR=3.03 (95 percentCI 1.56-5.88)] and CD4 counts < 200/mm³ [OR=1.14 (95 percentCI 1.09-1.18)] were associated with co-infection. This report emphasizes the significance of tuberculosis among AIDS cases in Brazil, and highlights the importance of evaluating secondary data for purposes of improving data quality and developing public health interventions.