[health menu] XI International Conference on AIDS
July 7-12, 1996

Nnorom, Joseph A.
USAID/Lagos, Nigeria

Esu-Williams, E.

Tilley-Gyado A.
NASCP, Nigeria


HIV, Tuberculosis and Syphilis in Nigeria: A Descriptive Study


  1. To determine the distribution by age group, of tuberculosis (TB), syphilis and HIV in Nigeria and to establish any association between these disease conditions.

  2. To estimate the male to female ratio of HIV and syphilis infections in Nigeria.

  3. To estimate the urban to rural ratio of HIV and syphilis infections in Nigeria.


The data used for this presentation was generated from the results of the 1993/94 national HIV/Syphilis sentinel serosurvey. The survey was carried out in seventeen of the thirty states in Nigeria, spread across the four health zones in the country. Seropositivity to an ELISA and a rapid/simple assay of different antigen preparation was considered positive for HIV, while positive test results to both RPR and MHTPA was considered positive for syphilis. A total of 14,796 samples from ante-natal patients, 1,937 from commercial sex workers, 2,502 from STD patients and 2,031 from TB patients were analyzed.


The distribution of TB, HIV and syphilis show identical patterns with 70%-90% of each infection distributed between the ages of 16-45. Each of these conditions (HIV, syphilis and TB), recorded its highest disease prevalence in (adolescents and young adults) in the 16-30 age group. A direct relationship between syphilis and HIV prevalence on one hand and HIV and TB prevalence on the other hand, was established and demonstrated by the observed (graphically presented) distribution pattern typical for sexually transmitted diseases.

The overall average for HIV prevalence for urban communities was 4.2%, while 2.4% was recorded for the rural communities, reflecting an urban-rural ratio of 2:1. Urban-rural ratio for syphilis prevalence was 1:1 (from prevalence rates of 3.0% and 3.8% respectively for urban and rural areas).

Of the four groups studied, the TB sentinel group is the most suitable for the estimation of the male-female ratio of HIV infections. A male-female ratio of 3:2 was established. Interestingly a similar (3:2) male-female ratio was established for syphilis infections in the same group.


TB prevalence increases as HIV prevalence increases. HIV epidemic therefore has grave implications for the control of tuberculosis. Cases of TB within the age bracket of 16-30 should be strongly considered for HIV screening and vice versa. Whereas the HIV prevalence rate for urban dwellers is twice that for rural communities, the syphilis rates for the urban and rural areas remain the same. Although estimates from the TB sentinel group show that the male-female of HIV prevalence is 3:2, the same ratio for syphilis prevalence, there is a need to further confirm this result using a "healthy" population.

HIV/STD interventions targeting adolescents and young adults should be pursued with greater vigour and commitment. In the same breath, rural areas should attract more attention than they presently receive. The need to utilize where appropriate, results from national surveys of this sort, for programmatic, as well as for diagnostic, prophylactic and therapeutic interventions cannot be overemphasized and should be encouraged.

J. A. Nnorom
USAID/Lagos, Global House
1601 Adeola Hopewell Street
Victoria Island, Box 554 Lagos, Nigeria
Tel: 234-1-2614621; Fax: 234-1-614698
Email: jnnorom@usaid.gov

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Created: July 16, 1996
Last modified: July 17, 1996

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