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Abstract
Background A retrospective cohort study was conducted to determine the situation, trend, and possible risk factors of TB infection, and factors related to the health status among the HIV/AIDS hill tribe in northern Thailand.
Methods A systematic data-reviewing approach was used to identify the information from the rosters of ARV clinics, OPD cards, and laboratory reports from 16 hospitals in Chiang Rai Province, Thailand. The data were collected from the first reported HIV/AIDS case of the hill tribe to the end of 2010. A chi-square test and logistic regression models were used to identify associations at the significance level of alpha = 0.05.
Results A total of 3,130 cases were included in the study. The majority of patients were Akha (46.0%) followed by Lahu (19.7%), 54.6% were males, 44.6% were 26–35 years old, and 25.2% were 36–45 years old. The peak period of HIV/AIDS infection among the hill tribes was from 2001–2005, during which occurred in 43.9% of all cases, followed by 33.7% from 2006–2010. The recorded occupations were 44.8% agricultural and 32.2% traders. The major risk factor of HIV infection was sexual intercourse (91.7%); 33.3% were still alive at the date of data collection, 30.7% were diagnosed with pulmonary TB, 76.0% did not receive ARV and 9.1% had been checked for CD4 level. The Lisu hill tribe HIV/AIDS individuals had a greater risk of TB infection than did Lahu individuals (ORadj = 1.50, 95% CI = 1.04–2.16). Females had a greater risk of TB infection than did males (ORadj = 1.22, 95% CI = 1.01–1.49); being classified as symptomatic HIV group was a protective factor of TB with ORadj = 0.18 (95% CI = 0.11–0.29); and not having received the ARV was also a protective factor with ORadj = 0.06 (95% CI = 0.05–0.08). The patients who had been diagnosed with HIV infection during 2001–2005 and 2006–2010 had a greater risk of TB infection than did those who were diagnosed from 1990–1995, with ORadj = 21.39 (6.59–69.42) and 13.70 (4.19–44.73), respectively.
Conclusions Thailand needs to create a TB and HIV/AIDS surveillance system for hill tribe populations to determine the situation and trend and to develop an appropriate model for providing care at the earlier stage of HIV/AIDS infection to prevent later TB infection.