The Indian Journal of Tuberculosis - LRS Institute of Tuberculosis ...
The Indian Journal of Tuberculosis - LRS Institute of Tuberculosis ... The Indian Journal of Tuberculosis - LRS Institute of Tuberculosis ...
4 V. SIVARAMAN ETAL (c) India The Indian Council of Medical Research (ICMR) in collaboration with the Directorate General of Health Services has built up a network of 43 surveillance and 5 reference centres to carry out a serosurveillance of HIV infection in the country. Of the 580,824 high-risk group persons screened during October 1985 to October 1990, 4,082 (7.0 per 1000) were found to be HIV positive, including 57 AIDS patients 11 - Extensive disseminated tuberculosis was seen only in 2 patients 113 Our group in Pondicherry screened 225 tuberculosis patients admitted in TB Sanatorium, and the method outlined by Murray 13 , a computerised mathematical model has been developed to estimate the impact of HIV infection on tuberculosis epidemiology within a wide range of assumptions : (1) Seroprevalance of HIV in general population varies from 0.07 to 1.75 per 1000 (i.e. 1 to 25% of the general population is at risk and 7 per 1000 among them develop HIV infection). (2) Seroprevalence of HIV among TB patients varies from 1% to 6% (corresponding to 95% confidence limits of our Pondicherry patients). Figure 2 shows the estimated impact of coinfection with HIV on the incidence of TB Fig. 1. Conceptual mode] of inter relationship of HIV infection and tuberculosis Pondicherry and suspected to be harbouring HIV infection and found 6 to be seropositives 12 . Applying the 95% confidence limits to this selective study, we can assume that roughly between 1% to 6% of the tuberculous patients might be HIV seropositive in this area. The assumption, based on so limited and selective data has been made in order to understand the relationship between HIV infection and tuberculosis, A conceptual model of the inter relationship between HIV and tuberculosis is shown in figure 1, along with the flow rates applicable to the Indian epidemiological conditions. Based on this disease. For a given Seroprevalance, the incidence among TB population shows very little variation when the seroprevalence in the community varies. Figure 3 shows time trend of the prevalence of TB under Indian conditions, with 3 different seroprevalence of HIV infection. The HIV related increase in the prevalence of tuberculosis may be considerable (The graph is computer generated from the model described by Sivaraman et al 14 The input parameters are the same as the program A but the incidence rate is higher and is derived by the method described by Murray 13 ).
Fig. 2. Estimated impact of HIV infection on TB incidence Note: The TB incidence per 100,000 may vary from 293.4 to 293.9, 299.5 to 300 and 309.0 to 309.6 when the seroprevalence of HIV among TB patients is 1%, 3%, 6% respectively (indicated below the curves). 2,55-1 2,30 Years (since 1987) Fig. 3. Impact of HIV infection on time trend of TB Note: NOHJV: A downward trend in prevalence of TB will be noted when there is no HIV infection in the community: It will decline from 2.52 per 1,000 to 2.36 per 1,000 over nine years. EHW: The estimated seroprevalence of HIV among tuberculosis patients is 2.7% from our observations in Pondicherry. The decline in the prevalence of TB will be from 2.52 per 1,000 to 2.41 per 1,000. HIH1V: If the highest limit of seroprevalence of HIV among TB patients i.e. 6% is assumed, the decline in prevalence of TB per thousand will be negligible and will be from 2.52 to 2.50 per 1,000.
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- Page 11 and 12: SCC AND EFFICIENCY VARIABLES IN DIS
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- Page 39 and 40: Case Report Ind. L Tub., 1992, 39,
- Page 41 and 42: UNUSUAL PRESENTATION OF TUBERCULOUS
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Fig. 2. Estimated impact <strong>of</strong> HIV infection on TB incidence<br />
Note: <strong>The</strong> TB incidence per 100,000 may vary from 293.4 to 293.9, 299.5 to 300 and 309.0 to 309.6 when the<br />
seroprevalence <strong>of</strong> HIV among TB patients is 1%, 3%, 6% respectively (indicated below the curves).<br />
2,55-1<br />
2,30<br />
Years (since 1987)<br />
Fig. 3. Impact <strong>of</strong> HIV infection on time trend <strong>of</strong> TB<br />
Note: NOHJV: A downward trend in prevalence <strong>of</strong> TB will be noted when there is no HIV infection in the<br />
community: It will decline from 2.52 per 1,000 to 2.36 per 1,000 over nine years.<br />
EHW: <strong>The</strong> estimated seroprevalence <strong>of</strong> HIV among tuberculosis patients is 2.7% from our observations in<br />
Pondicherry. <strong>The</strong> decline in the prevalence <strong>of</strong> TB will be from 2.52 per 1,000 to 2.41 per 1,000.<br />
HIH1V: If the highest limit <strong>of</strong> seroprevalence <strong>of</strong> HIV among TB patients i.e. 6% is assumed, the decline in<br />
prevalence <strong>of</strong> TB per thousand will be negligible and will be from 2.52 to 2.50 per 1,000.
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