Characteristics of sputum smear-positive tuberculosis patients with and without HIV infection in a hospital in Zimbabwe.

ABSTRACT

PIP: During April-September 1992, demographic, clinical, and bacteriological information was collected on all 467 tuberculosis (TB) patients aged 15 years and older admitted to the Driefontein Tuberculosis Sanatorium serving people from the Midlands and Masvingo provinces in Zimbabwe. 255 people had at least one sputum smear positive for acid-fast bacilli. Researchers retained 196 of these for analysis and compared demographic characteristics, clinical signs and symptoms, and radiographic appearance in TB patients with and without HIV infection. 127 (65%) people tested positive for HIV. HIV-infected TB patients were not significantly different compared to HIV-negative TB patients in age, gender, the period of delay between the onset of symptoms and diagnosis (about 2 months for both groups), radiographic appearance, history of previous anti-TB treatment, and symptoms and signs reported. They were more likely than HIV-negative TB patients to have a history of sexually transmitted diseases (adjusted odds ratio = 3.4; p = 0.01) and herpes zoster infection (9 vs. 0 patients). These findings suggest that health workers need not change case finding activities in the wake of the HIV epidemic. In conclusion, the most cost-effective intervention continues to be identification and curative treatment of sputum smear-positive TB patients irrespective of their HIV status.