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TB-HIV co-infection in the Netherlands: estimating prevalence and under-reporting in national registration databases using a capture–recapture analysis
  1. Frank van Leth1,
  2. Kirsten Evenblij2,
  3. Ferdinand Wit1,3,
  4. Albert Kiers4,
  5. Herman Sprenger5,
  6. Maurits Verhagen6,
  7. Mariska Hillebregt7,
  8. Nico Kalisvaart8,
  9. Henrieke Schimmel9,
  10. Annelies Verbon10
  1. 1Department of Global Health, Academic Medical Center, University of Amsterdam, Amsterdam Institute for Global Health and Development, Amsterdam, The Netherlands
  2. 2Amsterdam Institute for Global Health and Development, Amsterdam, The Netherlands
  3. 3Department of Internal Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
  4. 4Municipal Public Health Service Fryslân, Leeuwarden, The Netherlands
  5. 5Department of Internal Medicine, Infectious Diseases Service, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
  6. 6Municipal Public Health Service Limburg-Noord, Venlo, The Netherlands
  7. 7Stichting HIV Monitoring, Amsterdam, The Netherlands
  8. 8KNCV Tuberculosis Foundation, The Hague, The Netherlands
  9. 9National Institute for Public Health and Environment, Bilthoven, The Netherlands
  10. 10Department of Internal Medicine, Division of Infectious Diseases, Erasmus Medical Center, Rotterdam, The Netherlands
  1. Correspondence to Dr Frank van Leth, Department of Global Health, Academic Medical Center, Amsterdam Institute for Global Health and Development, Trinity Building C, Pietersbergweg 17, Amsterdam 1105 BM, The Netherlands; f.vanleth{at}aighd.org

Abstract

Background Knowledge of the HIV status in patients with tuberculosis (TB) and vice versa is crucial for proper individual patient management, while knowledge of the prevalence of co-infection guides preventive and therapeutic strategies. The aim of the study was to assess if national disease databases on TB and HIV are adequate sources to provide this information.

Methods A two way capture–recapture analysis to assess the completeness of the registers, and to obtain the prevalence of TB-HIV co-infection in the Netherlands in the years 2002–2012.

Results HIV testing was performed in less than 50% of the patients with TB. Of the 932 TB-HIV infected patients, just 293 (31.4%) were registered in both registers. Under-reporting of TB-HIV co-infection ranged from 50% to 70% in the national TB register, and from 31% to 37% in the HIV database. Prevalence of TB-HIV co-infection in the Netherlands in 2012 was 7.1% (95% CI 6.0% to 8.3%), which was more than double of the prevalence estimated from the national TB database.

Conclusions TB-HIV co-infection is markedly under-reported in national disease databases. There is an urgent need for improved registration and preferably a routine data exchange between the two surveillance systems.

  • PUBLIC HEALTH
  • TUBERCULOSIS
  • SURVEILLANCE

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