{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T19:39:36Z","timestamp":1776973176985,"version":"3.51.4"},"reference-count":30,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2025,5,8]],"date-time":"2025-05-08T00:00:00Z","timestamp":1746662400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100004417","name":"Global Fund to Fight AIDS, Tuberculosis and Malaria","doi-asserted-by":"publisher","award":["NGA\u2010H\u2010NACA"],"award-info":[{"award-number":["NGA\u2010H\u2010NACA"]}],"id":[{"id":"10.13039\/100004417","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009054","name":"U.S. President\u2019s Emergency Plan for AIDS Relief","doi-asserted-by":"publisher","award":["GH18\u20101813"],"award-info":[{"award-number":["GH18\u20101813"]}],"id":[{"id":"10.13039\/100009054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009054","name":"U.S. President\u2019s Emergency Plan for AIDS Relief","doi-asserted-by":"publisher","award":["GH002108"],"award-info":[{"award-number":["GH002108"]}],"id":[{"id":"10.13039\/100009054","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Tropical Med Int Health"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Nigeria bears a high burden of infectious diseases, with the second\u2010highest\u00a0human immunodeficiency virus (HIV)\u00a0prevalence globally and the largest tuberculosis (TB) burden in Africa. The country faces significant challenges from armed conflicts, insurgency, kidnapping and banditry, which severely strain its healthcare system, particularly for people living with HIV (PLHIV). This study hypothesizes that PLHIV in conflict\u2010affected regions of Nigeria experience a higher burden of TB than those in non\u2010conflict areas.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This cross\u2010sectional household survey utilised a two\u2010stage cluster sampling design to examine HIV\/TB co\u2010infection and associated behaviours in Nigeria, based on data from the 2018 Nigeria HIV\/ acquired immune deficiency syndrome (AIDS)\u00a0Indicator and Impact Survey. The sample included adults aged 15 to 64 in the selected households. We mapped the distribution of HIV\/TB co\u2010infection across the country and calculated its prevalence, stratified by conflict and non\u2010conflict zones. Adjusted odds ratios (AOR) and 95% confidence intervals (CIs) from survey\u2010weighted logistic regression models were used to assess the likelihood of being diagnosed with TB disease among PLHIV.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We analysed weighted data from 1,319,719 PLHIV across Nigeria, with 200,201(15.2%) residing in conflict zones and 1,119,518 (84.8%) in non\u2010conflict zones. Overall, the prevalence of HIV\/TB co\u2010infection was 40.4% (52,118), with PLHIV residents of conflict zones exhibiting a significantly higher prevalence (59%, 14,976) compared to those from non\u2010conflict zones (36%, 37,413). After adjusting for confounders, PLHIV in conflict zones were more than four times more likely to acquire TB than those from non\u2010conflict zones (AOR: 4.21, 95% CI: 1.72\u201310.5, <jats:italic>p<\/jats:italic>\u2009=\u20090.002).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Conflicts amplify the risk of TB among PLHIV in Nigeria, highlighting an urgent need for targeted interventions to strengthen healthcare access in these regions. The efforts are essential in achieving the goals of reducing TB prevalence by 50% and TB mortality by 75% by 2025, as well as meeting the 95\u201095\u201095 targets to control HIV by 2030.<\/jats:p><\/jats:sec>","DOI":"10.1111\/tmi.14112","type":"journal-article","created":{"date-parts":[[2025,5,8]],"date-time":"2025-05-08T08:43:38Z","timestamp":1746693818000},"page":"625-632","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["<scp>HIV<\/scp>\u2010tuberculosis co\u2010infection in conflict zones of Nigeria"],"prefix":"10.1111","volume":"30","author":[{"given":"Hamisu M.","family":"Salihu","sequence":"first","affiliation":[{"name":"Department of Epidemiology and Population Health Kano Independent Research Centre Trust (KIRCT)  Kano Nigeria"},{"name":"Population Health Program, and the International Center for the Advancement of Research &amp; Education (I\u2022CARE) Texas Biomedical Research Institute  San Antonio Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hassan A.","family":"Murtala","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Population Health Kano Independent Research Centre Trust (KIRCT)  Kano Nigeria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adam M.","family":"Murtala","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Population Health Kano Independent Research Centre Trust (KIRCT)  Kano Nigeria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aisha A.","family":"Abdullahi","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Population Health Kano Independent Research Centre Trust (KIRCT)  Kano Nigeria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Muhammad A.","family":"Abbas","sequence":"additional","affiliation":[{"name":"Office of the Director General Kano State Center for Disease Control and Prevention (KNCDC)  Kano Nigeria"},{"name":"Department of Community Medicine College of Health Sciences, Bayero University Kano  Kano Nigeria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abubakar L.","family":"Yusuf","sequence":"additional","affiliation":[{"name":"Office of the Commissioner of Health Kano State Ministry of Health  Kano Nigeria"},{"name":"Department of Medicine Federal University Dutse  Dutse Nigeria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Muktar H.","family":"Aliyu","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Vanderbilt Institute for Global Health Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sani H.","family":"Aliyu","sequence":"additional","affiliation":[{"name":"Department of Microbiology Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust  Cambridge UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ololade D.","family":"Adeyemi","sequence":"additional","affiliation":[{"name":"Research and Innovation Federal Ministry of Health and Social Welfare  Abuja Nigeria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deepa","family":"Dongarwar","sequence":"additional","affiliation":[{"name":"UTHealth Department of Neurosciences University of Texas Health Sciences Center  Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jordi B.","family":"Torrelles","sequence":"additional","affiliation":[{"name":"Population Health Program, and the International Center for the Advancement of Research &amp; Education (I\u2022CARE) Texas Biomedical Research Institute  San Antonio Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rahila A.","family":"Mukhtar","sequence":"additional","affiliation":[{"name":"Office of the Director General Kano State Healthcare Contributory Management Agency (KSCHMA)  Kano Nigeria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gambo","family":"Aliyu","sequence":"additional","affiliation":[{"name":"Office of the Director\u2010General National Agency for the Control of AIDS  Abuja Nigeria"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,5,8]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/MS9.0000000000000604"},{"key":"e_1_2_10_3_1","unstructured":"World Health Organization.WHO | Regional Office for Africa.2024. Intensifying new initiatives for TB case\u2010finding in Nigeria [cited 2024 Sep 20]. Available from:https:\/\/www.afro.who.int\/countries\/nigeria\/news\/intensifying-new-initiatives-tb-case-finding-nigeria"},{"key":"e_1_2_10_4_1","unstructured":"UNAIDS.Nigeria [Internet].2023[cited 2024 Sep 20]. Available from:https:\/\/www.unaids.org\/en\/regionscountries\/countries\/nigeria"},{"key":"e_1_2_10_5_1","unstructured":"Nigeria National HIV surveillance Report.Surveillance Reports \u2013 Nigeria National Data Repository [Internet].2023[cited 2024 Sep 20]. Available from:https:\/\/ndr.nascp.gov.ng\/public\/surveillance-report"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000032811"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.ppat.1002464"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-0691.2004.00758.x"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.3201\/eid1311.061093"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.ppat.1004438"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(12)70225-6"},{"key":"e_1_2_10_12_1","unstructured":"World Health Organization.Nigeria crisis [Internet]. [cited 2024 Sep 20]. Available from:https:\/\/www.who.int\/emergencies\/situations\/nigeria-crisis"},{"key":"e_1_2_10_13_1","unstructured":"Federal Ministry of Health N. Nigeria.HIV\/AIDS indicator and impact survey (NAIIS) 2018: technical report. Abuja Niger.2019."},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.5334\/aogh.3226"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.2196\/25752"},{"key":"e_1_2_10_16_1","first-page":"24","article-title":"Diagnosis of latent tuberculosis among HIV infected patients in Ilorin, Nigeria using tuberculin skin test and interferon gamma release assay","volume":"38","author":"Aladesanmi AO","year":"2021","journal-title":"Pan Afr Med J"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.8.12.897"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.2471\/BLT.06.037630"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijtb.2022.03.002"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.3390\/su131910783"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1186\/1752-1505-4-1"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijid.2016.05.011"},{"key":"e_1_2_10_23_1","unstructured":"KasetjaroenY LoveEJ TiwariSK Sitthi\u2010amornC WangJL.Prevalence of tuberculosis and service utilization in conflict affected areas of Nepal.2005[cited 2025 Feb 9]. Available from:http:\/\/elibrary.nhrc.gov.np:8080\/handle\/20.500.14356\/2152"},{"key":"e_1_2_10_24_1","unstructured":"First\u2010Line Drug Resistance Patterns ofMycobacterium tuberculosisComplex Isolates from Re\u2010Treatment Patients from Sudan [Internet]. [cited 2024 Sep 20]. Available from:https:\/\/www.scirp.org\/journal\/paperinformation?paperid=69845"},{"key":"e_1_2_10_25_1","unstructured":"Global Fund.Nigeria and Global Fund [Internet]. [cited 2025 Feb 9]. Available from:https:\/\/www.theglobalfund.org\/en\/updates\/2024\/2024-02-05-nigeria-global-fund-launch-new-grants-reinforce-progress-against-hiv-tb-malaria\/"},{"key":"e_1_2_10_26_1","unstructured":"World Health Organization.First WHO global ministerial conference: ending TB in the sustainable development era: a multisectoral response [Internet]. [cited 2024 Sep 19]. Available from:https:\/\/www.who.int\/publications\/i\/item\/WHO-HTM-TB-2017.11"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tube.2020.101925"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0272358"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jiph.2021.09.009"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.4314\/ahs.v21i3.6"},{"issue":"3","key":"e_1_2_10_31_1","first-page":"233","article-title":"Hubungan Jumlah Viral Load dengan Kejadian TBC pada Pasien HIV\/AIDS yang Mendapatkan Terapi ARV","volume":"1","author":"Baedowi A","year":"2020","journal-title":"Arteri J Ilmu Kesehat"}],"container-title":["Tropical Medicine &amp; International Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/tmi.14112","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,2]],"date-time":"2025-07-02T01:57:27Z","timestamp":1751421447000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/tmi.14112"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,8]]},"references-count":30,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2025,7]]}},"alternative-id":["10.1111\/tmi.14112"],"URL":"https:\/\/doi.org\/10.1111\/tmi.14112","archive":["Portico"],"relation":{},"ISSN":["1360-2276","1365-3156"],"issn-type":[{"value":"1360-2276","type":"print"},{"value":"1365-3156","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,8]]},"assertion":[{"value":"2025-05-08","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}