TB-HIV co-infection in the Netherlands: estimating prevalence and under-reporting in national registration databases using a capture-recapture analysis

J Epidemiol Community Health. 2016 Jun;70(6):556-60. doi: 10.1136/jech-2015-206680. Epub 2015 Dec 23.

Abstract

Background: Knowledge of the HIV status in patients with tuberculosis (TB) and vice versa is crucial for proper individual patient management, while knowledge of the prevalence of co-infection guides preventive and therapeutic strategies. The aim of the study was to assess if national disease databases on TB and HIV are adequate sources to provide this information.

Methods: A two way capture-recapture analysis to assess the completeness of the registers, and to obtain the prevalence of TB-HIV co-infection in the Netherlands in the years 2002-2012.

Results: HIV testing was performed in less than 50% of the patients with TB. Of the 932 TB-HIV infected patients, just 293 (31.4%) were registered in both registers. Under-reporting of TB-HIV co-infection ranged from 50% to 70% in the national TB register, and from 31% to 37% in the HIV database. Prevalence of TB-HIV co-infection in the Netherlands in 2012 was 7.1% (95% CI 6.0% to 8.3%), which was more than double of the prevalence estimated from the national TB database.

Conclusions: TB-HIV co-infection is markedly under-reported in national disease databases. There is an urgent need for improved registration and preferably a routine data exchange between the two surveillance systems.

Keywords: PUBLIC HEALTH; SURVEILLANCE; TUBERCULOSIS.

MeSH terms

  • Adolescent
  • Adult
  • Coinfection / epidemiology*
  • Disease Notification / standards
  • Disease Notification / statistics & numerical data*
  • Female
  • HIV Infections / epidemiology*
  • Humans
  • Male
  • Mass Screening / statistics & numerical data
  • Middle Aged
  • Netherlands / epidemiology
  • Population Surveillance
  • Prevalence
  • Public Health Informatics / standards
  • Public Health Informatics / statistics & numerical data*
  • Registries
  • Tuberculosis / epidemiology*