Prevalence Of Hiv/Aids In Tuberculosis Patients Living In The Lowlands Of Mafeteng District In Lesotho

Dissertation

Background: Tuberculosis (TB) is one of the oldest known diseases that kills humans, yet still remains among the top infectious disease killers worldwide today. The World Health Organization (WHO) states that up to 10 million people continue to fall ill with TB every year. Almost three-quarters of the TB infections are reported from the African region and almost a quarter of these are mentioned to be co-infected with human immunodeficiency virus (HIV) (WHO, 2018). WHO classified Lesotho as one of the countries carrying a large burden of TB/HIV co-infection in the Africa region (MOH, 2016). Therefore, this study was conducted in order to determine the prevalence of HIV among TB patients living in the lowlands of the Mafeteng district in Lesotho from 2014–2016. Methodology: A quantitative research approach was conducted by means of a convenience purposeful method of sampling. The method followed was to collect TB/HIV data from the five participating Health Care Centres (HCCs) for the years 2014 – 2016. These data were sourced from handwritten TB registries of the five identified HCCs and the sampling size of 1,109 study participants was selected from all age groups located in the lowlands of the Mafeteng district in Lesotho. Results: Out of the 1,109 TB patients studied, 780 (70.3%) were also co-infected with HIV. Among the HIV patients, the most prevalent site of TB infection was pulmonary including a total of 665 patients (85.3%), while 115 (14.7%) had extra-pulmonary TB (ET-TB). The number of new TB patients with HIV was 638 (81.2%) and retreated patients numbered 142 (18.2%). A total of 457 (41.2%) fell in the mean age group of 15 to 35 years. 99% of these co-infected patients were receiving anti-retroviral therapy (ART). Most of these HIV/AIDS patients were from the Mafeteng HCC with 501 (64.2%) of the 1,109 patients. The most affected age group among the patients were the young adult age group (>15 to 35 years) and the adult age group (>35 to 55 years) with 45.8% and 40.6% of the total 780 HIV/AIDS patients, respectively. The distribution of male HIV/AIDS patients among the participating HCCs was 470 (60.3%), while the distribution of female HIV/AIDS patients among the participating HCCs was 310 (39.7%) of the total 780 HIV/AIDS co-infected patients. Most of these HIV/AIDS patients were reported from the Mafeteng main HCC. Discussion: In this study, TB notification cases declined substantially when comparing reporting Year 1 and 2 with reporting Year 3. It was also interesting to take note that the number of HIV/AIDS cases in the most affected young adult age group interval (>15 to 35) dropped in reporting Year 3. Ultimately, the number of HIV/AIDS cases in the age group interval of adults (>35 to 55) was more in reporting Year 3 compared with the number of cases in the young adult group in the same reporting year. Conclusion: The findings of the study concluded that there is a high prevalence of HIV/AIDS among TB patients living in the lowlands of the Mafeteng district in Lesotho. Therefore, National and district level administrative bodies and health care centres should collaborate to strengthen the efforts and place TB and HIV/AIDS services among their priority interventions. These include identifying the possible routes of TB transmission because of limited infection control measures, drug resistance, poor TB prognosis and adherence to treatment. Future researchers could consider assessing the main reasons behind the high prevalence of HIV/AIDS among male TB patients in the Mafeteng district of Lesotho.