Transactions of the Royal Society of Tropical Medicine and Hygiene
Volume 103, Issue 12 , Pages 1187-1189, December 2009

HIV and the risk of tuberculosis due to recent transmission over 12 years in Karonga District, Malawi☆

  • Rein M.G.J. Houben

      Affiliations

    • Karonga Prevention Study, Malawi
    • Infectious Disease Epidemiology Unit, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK
    • Corresponding Author InformationCorresponding author. Tel.: +44 20 7927 2668; fax: +44 20 7637 4314.
    • ,
  • Amelia C. Crampin

      Affiliations

    • Karonga Prevention Study, Malawi
    • Infectious Disease Epidemiology Unit, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK
    • ,
  • Kim Mallard

      Affiliations

    • Pathogen Molecular Biology Unit, London School of Hygiene and Tropical Medicine, London, UK
    • ,
  • J. Nimrod Mwaungulu

      Affiliations

    • Karonga Prevention Study, Malawi
    • ,
  • Malcolm D. Yates

      Affiliations

    • Mycobacterium Reference Unit, Health Protection Agency, London, UK
    • ,
  • Frank D. Mwaungulu

      Affiliations

    • Karonga Prevention Study, Malawi
    • Deceased.
    • ,
  • Bagrey M.M. Ngwira

      Affiliations

    • Karonga Prevention Study, Malawi
    • Infectious Disease Epidemiology Unit, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK
    • ,
  • Neil French

      Affiliations

    • Karonga Prevention Study, Malawi
    • Infectious Disease Epidemiology Unit, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK
    • ,
  • Paul E.M. Fine

      Affiliations

    • Karonga Prevention Study, Malawi
    • Infectious Disease Epidemiology Unit, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK
    • ,
  • Judith R. Glynn

      Affiliations

    • Karonga Prevention Study, Malawi
    • Infectious Disease Epidemiology Unit, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK

Received 6 March 2009; received in revised form 11 March 2009; accepted 12 March 2009.

Summary 

Tuberculosis (TB) patients with strains common to other recent cases (‘clustering’) suggest recent transmission. HIV status and age may affect proportions clustered. We investigated TB clustering by HIV and age in a population-based study in Malawi. Among 746 patients, HIV infection increased the proportion clustered. Sex-period-adjusted odds ratios for the association of HIV and clustering were 1.26 (95% CI 0.4–4.1) for ages 15–25 years, 1.40 (0.9–2.3) for 25–50 years and 10.44 (2.3–47.9) for >50 years and remained stable over two periods examined. These results suggest that HIV increases the proportion of TB due to recent transmission in the elderly.

Keywords: HIV, Tuberculosis, Mycobacterium tuberculosis, Molecular epidemiology, Transmission, Malawi

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☆ Based on a presentation to the Royal Society of Tropical Medicine & Hygiene Research in Progress meeting on 18 December 2008. This oral presentation was awarded third prize at the meeting.

PII: S0035-9203(09)00099-6

doi:10.1016/j.trstmh.2009.03.013

Transactions of the Royal Society of Tropical Medicine and Hygiene
Volume 103, Issue 12 , Pages 1187-1189, December 2009

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