Fight Against TB, HIV: Bangladesh poised to reach targets

One in every 1,000 tuberculosis (TB) patient in Bangladesh has HIV, found a recent study -- in what can be viewed as a boost to the country's bid to end the infectious disease and meet 90-90-90 targets for HIV by 2030.

Bangladesh -- which is a low-level HIV prevalent country and one of the 30 high TB-burden countries, accounting for 3.6 percent of the global total -- is committed to the two targets as part of the Sustainable Development Goals.

People living with HIV are more likely than others to become sick with TB as HIV weakens the immune system, making it harder for the body to fight TB germs. Globally, TB is one of the leading causes of death among people with HIV.

HIV prevalence among tuberculosis patients in Bangladesh was 0.1 percent, found the study styled "HIV Sero Survey among Tuberculosis Patients in Bangladesh, 2019-2020" conducted by the National Institute of Preventive and Social Medicine (NIPSOM) under the Directorate General of Health Services.

The result is very positive for Bangladesh as HIV prevalence in TB patients is a sensitive indicator of the spread of HIV into the general population, said Baizid Khoorshid Riaz, principal investigator and director of NIPSOM.

As the HIV epidemic continues to fuel the global TB epidemic, the surveillance of HIV among TB patients is increasingly recognised as an important tool for the management of both TB and HIV.

"We have to keep the transmission under control and if we can do that, we can achieve the SDG target," he told The Daily Star yesterday, ahead of the unveiling of the findings of the study, the first-of-its-kind, today.

A nationwide cross-sectional survey was conducted among 12,065 TB patients managed by the TB Reporting Centre (TRC) of the National Tuberculosis Control Programme (NTP) from June to December 2020.

Tuberculosis remains a public health concern as 129 people die of infectious disease every day in Bangladesh, according to the data of the government in 2019.

The disease also makes 978 people ill every day, according to the NTP.

At least 3.57 lakh TB patients are identified in a year in Bangladesh, with an incidence rate of 221 per lakh and mortality of 29 per lakh, according to the data.

Every year, at least 5,900 TB patients are identified with multi-drug resistance, which is concerning, the report said.

Among them, 1.5 percent are new patients and 4.9 percent are previously-treated patients but re-diagnosed with the drug-resistant TB bacteria.

"The good news is that not a single HIV positive case was found among drug-resistant TB patients, as they are the most vulnerable patients," Riaz said.

As none of the HIV positive cases had any history of blood transfusion, it indicates the country's blood transfusion system is safe at large.

The study also found that none of the TB-infected third gender was detected with HIV.

Out of the samples, only 12 TB patients was found with HIV positive and among them four were housewives.

It means either their husbands are HIV positives or they infected by other means, according to Riaz.

The study found that the prevalence of HIV among the TB patients was same for both the male and female.

The report also found that of those who are infected with HIV, 83 percent were suffering from pulmonary tuberculosis.

When it comes to occupation, the study found that HIV prevalence was also found higher among transport labours and day labourers.