Hamisu M Salihu, Hassan A Murtala, Adam M Murtala, Aisha A Abdullahi, Muhammad A Abbas, Abubakar L Yusuf, Muktar H Aliyu, Sani H Aliyu, Ololade D Adeyemi, Deepa Dongarwar, Jordi B Torrelles, Rahila A Mukhtar, Gambo Aliyu
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This study hypothesizes that PLHIV in conflict-affected regions of Nigeria experience a higher burden of TB than those in non-conflict areas.</p><p><strong>Methods: </strong>This cross-sectional household survey utilised a two-stage cluster sampling design to examine HIV/TB co-infection and associated behaviours in Nigeria, based on data from the 2018 Nigeria HIV/ acquired immune deficiency syndrome (AIDS) Indicator and Impact Survey. The sample included adults aged 15 to 64 in the selected households. We mapped the distribution of HIV/TB co-infection across the country and calculated its prevalence, stratified by conflict and non-conflict zones. Adjusted odds ratios (AOR) and 95% confidence intervals (CIs) from survey-weighted logistic regression models were used to assess the likelihood of being diagnosed with TB disease among PLHIV.</p><p><strong>Results: </strong>We analysed weighted data from 1,319,719 PLHIV across Nigeria, with 200,201(15.2%) residing in conflict zones and 1,119,518 (84.8%) in non-conflict zones. Overall, the prevalence of HIV/TB co-infection was 40.4% (52,118), with PLHIV residents of conflict zones exhibiting a significantly higher prevalence (59%, 14,976) compared to those from non-conflict zones (36%, 37,413). After adjusting for confounders, PLHIV in conflict zones were more than four times more likely to acquire TB than those from non-conflict zones (AOR: 4.21, 95% CI: 1.72-10.5, p = 0.002).</p><p><strong>Conclusions: </strong>Conflicts amplify the risk of TB among PLHIV in Nigeria, highlighting an urgent need for targeted interventions to strengthen healthcare access in these regions. The efforts are essential in achieving the goals of reducing TB prevalence by 50% and TB mortality by 75% by 2025, as well as meeting the 95-95-95 targets to control HIV by 2030.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":"625-632"},"PeriodicalIF":2.3000,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"HIV-tuberculosis co-infection in conflict zones of Nigeria.\",\"authors\":\"Hamisu M Salihu, Hassan A Murtala, Adam M Murtala, Aisha A Abdullahi, Muhammad A Abbas, Abubakar L Yusuf, Muktar H Aliyu, Sani H Aliyu, Ololade D Adeyemi, Deepa Dongarwar, Jordi B Torrelles, Rahila A Mukhtar, Gambo Aliyu\",\"doi\":\"10.1111/tmi.14112\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Nigeria bears a high burden of infectious diseases, with the second-highest human immunodeficiency virus (HIV) prevalence globally and the largest tuberculosis (TB) burden in Africa. The country faces significant challenges from armed conflicts, insurgency, kidnapping and banditry, which severely strain its healthcare system, particularly for people living with HIV (PLHIV). This study hypothesizes that PLHIV in conflict-affected regions of Nigeria experience a higher burden of TB than those in non-conflict areas.</p><p><strong>Methods: </strong>This cross-sectional household survey utilised a two-stage cluster sampling design to examine HIV/TB co-infection and associated behaviours in Nigeria, based on data from the 2018 Nigeria HIV/ acquired immune deficiency syndrome (AIDS) Indicator and Impact Survey. The sample included adults aged 15 to 64 in the selected households. We mapped the distribution of HIV/TB co-infection across the country and calculated its prevalence, stratified by conflict and non-conflict zones. Adjusted odds ratios (AOR) and 95% confidence intervals (CIs) from survey-weighted logistic regression models were used to assess the likelihood of being diagnosed with TB disease among PLHIV.</p><p><strong>Results: </strong>We analysed weighted data from 1,319,719 PLHIV across Nigeria, with 200,201(15.2%) residing in conflict zones and 1,119,518 (84.8%) in non-conflict zones. Overall, the prevalence of HIV/TB co-infection was 40.4% (52,118), with PLHIV residents of conflict zones exhibiting a significantly higher prevalence (59%, 14,976) compared to those from non-conflict zones (36%, 37,413). After adjusting for confounders, PLHIV in conflict zones were more than four times more likely to acquire TB than those from non-conflict zones (AOR: 4.21, 95% CI: 1.72-10.5, p = 0.002).</p><p><strong>Conclusions: </strong>Conflicts amplify the risk of TB among PLHIV in Nigeria, highlighting an urgent need for targeted interventions to strengthen healthcare access in these regions. 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引用次数: 0
摘要
背景：尼日利亚传染病负担沉重，是全球人类免疫缺陷病毒（HIV）流行率第二高的国家，也是非洲结核病负担最重的国家。该国面临着武装冲突、叛乱、绑架和盗匪等重大挑战，这些挑战严重影响了该国的医疗系统，尤其是艾滋病毒感染者。本研究假设尼日利亚受冲突影响地区的艾滋病毒感染者的结核病负担高于非冲突地区。方法：本横断面家庭调查采用两阶段整群抽样设计，根据2018年尼日利亚艾滋病毒/获得性免疫缺陷综合征（艾滋病）指标和影响调查的数据，检查尼日利亚艾滋病毒/结核病合并感染和相关行为。样本包括所选家庭中15至64岁的成年人。我们绘制了艾滋病毒/结核病合并感染在全国的分布图，并按冲突地区和非冲突地区分层计算了其患病率。采用调查加权logistic回归模型的校正优势比（AOR）和95%置信区间（CIs）来评估PLHIV患者被诊断为结核病的可能性。结果：我们分析了尼日利亚1,319,719例PLHIV的加权数据，其中200,201例（15.2%）居住在冲突地区，1,119,518例（84.8%）居住在非冲突地区。总体而言，HIV/TB合并感染的患病率为40.4%(52,118)，冲突地区的PLHIV居民的患病率（59%,14,976）明显高于非冲突地区的患病率（36%,37,413）。在调整混杂因素后，冲突地区的艾滋病毒感染者获得结核病的可能性是非冲突地区的四倍多（AOR: 4.21, 95% CI: 1.72-10.5, p = 0.002）。结论：冲突加剧了尼日利亚艾滋病毒感染者患结核病的风险，因此迫切需要采取有针对性的干预措施，以加强这些地区的医疗服务可及性。这些努力对于实现到2025年将结核病患病率降低50%和结核病死亡率降低75%的目标以及实现到2030年控制艾滋病毒的95-95-95具体目标至关重要。
HIV-tuberculosis co-infection in conflict zones of Nigeria.
Background: Nigeria bears a high burden of infectious diseases, with the second-highest human immunodeficiency virus (HIV) prevalence globally and the largest tuberculosis (TB) burden in Africa. The country faces significant challenges from armed conflicts, insurgency, kidnapping and banditry, which severely strain its healthcare system, particularly for people living with HIV (PLHIV). This study hypothesizes that PLHIV in conflict-affected regions of Nigeria experience a higher burden of TB than those in non-conflict areas.
Methods: This cross-sectional household survey utilised a two-stage cluster sampling design to examine HIV/TB co-infection and associated behaviours in Nigeria, based on data from the 2018 Nigeria HIV/ acquired immune deficiency syndrome (AIDS) Indicator and Impact Survey. The sample included adults aged 15 to 64 in the selected households. We mapped the distribution of HIV/TB co-infection across the country and calculated its prevalence, stratified by conflict and non-conflict zones. Adjusted odds ratios (AOR) and 95% confidence intervals (CIs) from survey-weighted logistic regression models were used to assess the likelihood of being diagnosed with TB disease among PLHIV.
Results: We analysed weighted data from 1,319,719 PLHIV across Nigeria, with 200,201(15.2%) residing in conflict zones and 1,119,518 (84.8%) in non-conflict zones. Overall, the prevalence of HIV/TB co-infection was 40.4% (52,118), with PLHIV residents of conflict zones exhibiting a significantly higher prevalence (59%, 14,976) compared to those from non-conflict zones (36%, 37,413). After adjusting for confounders, PLHIV in conflict zones were more than four times more likely to acquire TB than those from non-conflict zones (AOR: 4.21, 95% CI: 1.72-10.5, p = 0.002).
Conclusions: Conflicts amplify the risk of TB among PLHIV in Nigeria, highlighting an urgent need for targeted interventions to strengthen healthcare access in these regions. The efforts are essential in achieving the goals of reducing TB prevalence by 50% and TB mortality by 75% by 2025, as well as meeting the 95-95-95 targets to control HIV by 2030.
期刊介绍：
Tropical Medicine & International Health is published on behalf of the London School of Hygiene and Tropical Medicine, Swiss Tropical and Public Health Institute, Foundation Tropical Medicine and International Health, Belgian Institute of Tropical Medicine and Bernhard-Nocht-Institute for Tropical Medicine. Tropical Medicine & International Health is the official journal of the Federation of European Societies for Tropical Medicine and International Health (FESTMIH).
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