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Epidemiology and policy
P1-279 Trend analysis of HIV/tuberculosis co-infection in SÃo Paulo State (SPS), Brazil, from 1998 to 2009
  1. M J P Rujuila,
  2. V M N Galesi,
  3. N Goldgrub,
  4. L A R Santos,
  5. S Fukasava
  1. Tuberculosis Division, Sao Paulo State Secretary of Health, Sao Paulo, SP, Brazil

Abstract

Introduction SPS notified 18 228 cases of tuberculosis (Tb) in 2009. The study of endemia trend since 1998 (49.3/100 000 inhabitants) points towards declining incidence rates (IR) of 37.9/100 000 inhabitants, showing a decrease of 23.7% up to 2009. In 1998, 16% of Tb cases were HIV+; in 2009, the co-infection fell to 12%.

Objectives Study TB/AIDS co-infection trend in SPS, 1998–2009.

Methodology Case numbers were found on SPS/Tb information database system.

Results The co-infection IR decreased from 7.3 in 1998 to 4.2 in 2009 showing a linear declining trend (R2=0.89). This trend was maintained for clinical forms, with the extra-pulmonary (EP) having declined from 1.74 (1998) to 1.33 (2009) (R2=0.77) and the pulmonary decreasing from 5.56 to 2.83 (R2=0.95). The 15–49 years old group was the most affected. Male co-infection IR was twice the female. Treatment outcomes in co-infected patients—in spite of having improved, the cure rates in 1998 (37.2%) compared to 2009 (54.4%)—were well below the non co-infected patients (78% in 2009). Default rates of co-infected also declined from 23.3% (1998) to 18.7% in 2009. Although showing a slight decline from 23.9 % in 1998 to 21.8 % in 2009, mortality rates deserve our worries.

Conclusions Overall, the results point out to a declining co-infection trend. However treatment outcomes are quite worrisome; the cure of co-infected patients, being lower than the non co-infected, demonstrate the need to create priorities and adequate strategies for this population, mainly regarding the follow-up of these cases.

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