Tuberculosis among people living with HIV/AIDS in Jazan Region, Southwestern Saudi Arabia

Majid A Darraj; Ahmed A Abdulhaq; Abuobaida Yassin; Sultan Mubarki; Heba M Shalaby; Yoav Keynan; Khalid Y Ghailan; Hesham M Al-Mekhlafi

doi:10.1016/j.jiph.2021.09.009

Tuberculosis among people living with HIV/AIDS in Jazan Region, Southwestern Saudi Arabia

J Infect Public Health. 2021 Nov;14(11):1571-1577. doi: 10.1016/j.jiph.2021.09.009. Epub 2021 Sep 30.

Authors

Majid A Darraj¹, Ahmed A Abdulhaq², Abuobaida Yassin³, Sultan Mubarki⁴, Heba M Shalaby⁵, Yoav Keynan⁶, Khalid Y Ghailan⁷, Hesham M Al-Mekhlafi⁸

Affiliations

¹ Department of Internal Medicine, Faculty of Medicine, Jazan University, Jazan, Saudi Arabia. Electronic address: darraj@ymail.com.
² Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, Jazan University, Jazan, Saudi Arabia.
³ Department of Internal Medicine, Faculty of Medicine, Jazan University, Jazan, Saudi Arabia.
⁴ King Fahd Central Hospital, Jazan, Saudi Arabia.
⁵ Faculty of Medicine, Ain Shams University, Cairo, Egypt.
⁶ Department of Internal Medicine, Department of Medical Microbiology and Infectious Diseases, Max Rady College of Medicine, University of Manitoba, Winnipeg, Canada.
⁷ Faculty of Public Health and Tropical Medicine, Jazan University, Jazan, Saudi Arabia.
⁸ Medical Research Centre, Jazan University, Jazan, Saudi Arabia; Department of Parasitology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia; Department of Parasitology, Faculty of Medicine and Health Sciences, Sana'a University, Sana'a, Yemen. Electronic address: halmekhlafi@yahoo.com.

PMID: 34656963
DOI: 10.1016/j.jiph.2021.09.009

Abstract

Background: Tuberculosis (TB) and human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) infections are leading causes of morbidity and mortality worldwide. People living with HIV/AIDS (PLWHA) are highly susceptible to TB infection and progression to active TB disease. This study aims to determine the proportion and risk factors of TB among PLWHA in Jazan Region, southwestern Saudi Arabia.

Methods: A cross-sectional study was conducted among HIV-infected individuals attending the main referral hospital in Jazan Region during the period 2017-2019. The participants' TB status, CD4+ lymphocyte count, and viral load were assessed. In addition, their demographic and clinical information was collected using a structured questionnaire.

Results: A total of 316 HIV-positive individuals aged between 13 and 81 years (75% male and 25% female) were enrolled in this study. Of them, 30 (9.5%; 95% confidence interval [CI]: 5.2, 10.6%) were diagnosed with TB: 46.7% (14/30) had pulmonary TB and 53.3% (16/30) had extrapulmonary TB. The highest proportion of TB-positive PLWHA was found among participants aged 18-30 years (11.6%) and among non-Saudis (14.0%) when compared to other age groups and Saudi participants (7.4%). Multivariate analysis showed that male gender (adjusted odds ratio [AOR] = 4.79; 95% CI = 1.22, 18.74), past medical history (PMH) of TB (AOR = 29.67; 95% CI = 5.31, 164.32), PMH of other RTIs (AOR = 5.86; 95 % CI = 2.14, 16.06), CD4+ lymphocyte count of <200 cells/mm³ (AOR = 4.33; 95% CI = 1.65, 11.36), and viral load of ≥1 × 10³ copies/mL (AOR = 5.46; 95% CI = 2.02, 14.77) were the significant risk factors of TB among the studied PLWHA.

Conclusion: The prevalence of TB/HIV co-infection among the studied population was 9.5%. Therefore, all PLWHA should be screened for TB at every visit to a health facility. The findings highlight that integration of health services for both TB and HIV/AIDS in Saudi Arabia is recommended.

Keywords: Infectious diseases; PLWHA; Risk factors; Saudi Arabia; TB-HIV co-infection.

MeSH terms

Acquired Immunodeficiency Syndrome*
Adolescent
Adult
Aged
Aged, 80 and over
Cross-Sectional Studies
Female
HIV Infections* / complications
HIV Infections* / epidemiology
Humans
Male
Middle Aged
Risk Factors
Saudi Arabia / epidemiology
Tuberculosis* / complications
Tuberculosis* / epidemiology
Young Adult