Tuberculosis with malaria or HIV co-infection in a large hospital in Luanda, Angola

  • Emília Valadas Clínica Universitária de Doenças Infecciosas e Parasitárias, Faculdade de Medicina da Universidade de Lisboa, Portugal
  • Augusto Gomes Clínica Universitária de Doenças Infecciosas e Parasitárias, Faculdade de Medicina da Universidade de Lisboa, Portugal
  • Ana Sutre Clínica Universitária de Doenças Infecciosas e Parasitárias, Faculdade de Medicina da Universidade de Lisboa, Portugal
  • Sara Brilha Clínica Universitária de Doenças Infecciosas e Parasitárias, Faculdade de Medicina da Universidade de Lisboa, Portugal
  • Afonso Wete Hospital Sanatório de Luanda, Luanda, Angola
  • Thomas Hänscheid Instituto de Microbiologia and Instituto de Microbiologia Molecular, Faculdade de Medicina da Universidade de Lisboa, Portugal
  • Francisco Antunes Clínica Universitária de Doenças Infecciosas e Parasitárias, Faculdade de Medicina da Universidade de Lisboa, Portugal
Keywords: tuberculosis, HIV, malaria, co-infection, Angola

Abstract

Introduction: Three major public health problems, tuberculosis, malaria and HIV/AIDS, are widespread in Angola, often as co-infections in the same individual. In 2009, it was assumed that 44,151 new cases of TB occurred in Angola. Interestingly, interventions such as treatment/prevention of malaria appear to reduce mortality in HIV-infected and possibly TB co-infected patients. However, despite the seriousness of the situation, current data on TB and co-infection rates are scarce.

This study aimed to characterize all TB cases seen at the Hospital Sanatório de Luanda, and to determine the co-infection rate with HIV and/or malaria.

Methodology: This retrospective study collected demographic, diagnostic and clinical data from all patients admitted during 2007.

Results: A total of 4,666 patients were admitted, of whom 1,906 (40.8%) were diagnosed with TB. Overall, 1,111 patients (58.3%) were male and most patients (n=1302, 68.3%) were adults (≥14 years). The rate of HIV co-infection was 37.4% (n=712).  Malaria was diagnosed during admission and hospital stay in 714 patients (37.5%), with Plasmodium falciparum the predominant species. Overall mortality was 15.2% (n=290).

Conclusions: Because Luanda does not have the infrastructure to perform culture-based diagnosis of TB, confirmation of TB is problematic. The HIV-co-infection rate is high, with 37.4% of patients requiring integrated approaches to address this problem. With more than 1/3 of the TB patients co-infected with malaria, even during the hospital stay, the prevention of malaria in TB patients appears to be an effective way to reduce overall mortality.

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Published
2013-03-14
How to Cite
1.
Valadas E, Gomes A, Sutre A, Brilha S, Wete A, Hänscheid T, Antunes F (2013) Tuberculosis with malaria or HIV co-infection in a large hospital in Luanda, Angola. J Infect Dev Ctries 7:269-272. doi: 10.3855/jidc.2703
Section
Brief Original Articles