Public-private mix for TB and TB-HIV care in Lagos, Nigeria.

SETTING: Private and public tuberculosis (TB) treatment centres in Lagos State, Nigeria. OBJECTIVE: To assess the contribution of private health care providers to TB and TB-HIV (human immunodeficiency virus) case finding in Lagos State. DESIGN: A retrospective review of programme data submitted to the Lagos State TB and Leprosy Control Programme in 2011 by public, private for-profit (PFP) and private not-for-profit (PNFP) health care providers. RESULTS: A total of 8425 TB cases were notified by 31 private (11 PFP and 20 PNFP) and 99 public health facilities in Lagos State. Overall, the private facilities were responsible for 10.3% (866/8425) of the total TB cases notified. The proportion of TB patients tested for HIV was respectively 86.2%, 53.1% and 96.5% among public, PFP and PNFP facilities. Overall, 22.4% of the TB patients were HIV-positive. The HIV positivity rate among public, PFP and PNFP facilities was respectively 23.8%, 7.8% and 9.9%. Uptake of cotrimoxazole preventive therapy was respectively 69.6%, 25% and 38.2% among public, PFP and PNFP facilities, while that of antiretroviral therapy was respectively 23.8%, 8.3% and 9.1% in public, PFP and PNFP facilities. CONCLUSION: There is a need to scale up collaboration with the private sector, and particularly PNFP health providers.

HIV sero-prevalence among newly diagnosed adult pulmonary tuberculosis patients in Sagamu.

BACKGROUND: [corrected] The association between Tuberculosis (TB) and Human immunodeficiency virus (HIV) has been described in several studies. TB was well represented in the first description of AIDS in Africa. In 1999, 25% of TB cases were attributable to the spread of HIV/AIDS. Frequencies of between 54-79% were recorded in medical in-patients in our hospital. The objective of the study is to assess the frequency of HIV in TB outpatients attending the tuberculosis and leprosy control centre in Sagamu. METHODS: A cross-sectional study of adult tuberculosis patients admitted into the DOTS programme of the TB and leprosy control centre, Olabisi Onabanjo University Teaching Hospital, Sagamu between January 2001 and December 2002 was undertaken. Free anti tuberculosis drugs were provided by the German leprosy Relief Association. Data was collected using interviewer-administered questionnaire. HIV screening, packed cell volume and sputum microscopy for acid fast bacilli were carried out on all patients. RESULTS: A total of 269 cases of pulmonary T.B were registered at the clinic of which 40 (14.9%) were HIV sero-positive. The peak age prevalence was in the 3d decade accounting for 42.5% of cases, followed by 32.5% in the 2rd decade. There was a statistically significant difference in the bacillary count and packed cell volume between HIV positive and negative TB patients. The mean weight at presentation, sputum positivity rate and sputum conversion rate at the end of two months of therapy was similar in both HIV positive and negative TB patients. CONCLUSION: This study has demonstrated a frequency of 14.9% of HIV sero-prevalence amongst our TB population. Efforts should be intensified to ensure adherence to INH prophylaxis among HIV infected individuals in TB endemic areas as well as strengthening preventive measures.