Coinfection of Tuberculosis and HIV in Nigeria: A Systematic Review and Meta-analysis.

Abstract

Tuberculosis (TB) and HIV/AIDS are major public health issues globally. The burden of these diseases is particularly significant in Nigeria due to the high TB and HIV/AIDS prevalence. This meta-analysis for the 1st time addressed the TB/HIV coinfection prevalence in Nigeria at the regional level. A total of 58 relevant publications comprising 80 studies (n = 44,508) were obtained from PUBMED, ScienceDirect, African Journals Online, and Cochrane Library databases using carefully constructed keywords combinations. The PRISMA guideline was followed for this meta-analysis. Two independent reviewers conducted the publication screening, data extraction and methodological quality appraisal with a third reviewer serving as arbitrator. The pooled estimates were calculated using the random effects model. Heterogeneity was assessed using Cochran's Q and I 2 statistic. Univariate and multivariate meta-regressions were done to predict sources of between-study heterogeneity. Overall, the pooled prevalence of TB/HIV coinfection was 25.8%. The highest coinfection prevalence of 34.3% was recorded among the North Central States of Nigeria, while the least prevalence of 19.3% was recorded among the Southeastern states of Nigeria. There was a paucity of published articles from the Northeastern states of Nigeria. There was a significant heterogeneity between studies (I2 > 90%, p < 0.001), but meta-regression analysis only explained < 10% of it. This study has shown that the prevalence of TB/HIV coinfection remains significantly high in Nigeria. Constant surveillance should be rigorously implemented with special attention given to the Northeast due to the ongoing crises that are compounding the problem.