Outcomes of TB treatment in HIV co-infected TB patients in Ethiopia: a cross-sectional analytic study

Abstract

BackgroundTB and HIV are the most prevalent communicable diseases of major public health importance in the populations of sub-Saharan African countries, and an estimated 30 % of HIV infected persons have dual infection with TB. TB is the leading cause of death in HIV infected individuals, and HIV co-infected TB patients have multiple individual, disease specific and treatment related factors that can adversely affect their treatment outcomes. There is lack of evidence on the individual patient outcomes of HIV co-infected TB patients who receive anti-TB treatment. It is relevant to understand the differential patient outcomes of HIV co-infected TB patients and identify the factors that are associated with these outcomes.MethodsA comparative analysis was done on the data from a random sample of 575 TB patients who were enrolled for TB treatment from January 2013 to December 2013 at eight health facilities in Ethiopia. A descriptive analysis was done on the data, and chi-square test and logistic regression analysis was conducted to compare TB treatment outcomes based on HIV status and to identify factors associated with these outcomes.ResultsOut of a total of 575 TB patients enrolled into the study, 360 (62.6 %) were non-HIV infected, 169 (29.4 %) were HIV co-infected, and 46 (8 %) had no documented HIV status. The overall treatment success rate was 91.5 % for all the study participants. HIV co-infected TB patients have a treatment success rate of 88.2 % compared with 93.6 % for non-HIV infected study participants (P = 0.03). HIV co-infected TB patients had a significantly higher rate (11.8 % versus 6.4 %, P = 0.03) of unfavourable outcomes. The cure rate was significantly lower (10.1 % versus 24.2 %, P = 0.001) and the death rate higher in HIV co-infected TB patients (8.3 % versus 2.5 %, P = 0.014). Age and TB classification were significantly associated with treatment outcome. No association was found with starting ART, Cotrimoxazole prophylactic treatment or enrolment in HIV care.ConclusionsThere is high TB treatment success rate among patients who have been treated for TB, but the treatment success rate and the cure rate in HIV co-infected TB patients is lower than that observed in non-HIV infected patients. Patients with advanced age and those with smear positive pulmonary TB have unfavourable treatment outcomes.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-016-1967-3) contains supplementary material, which is available to authorized users.

Treatment outcomes of tuberculosis patients under directly observed treatment short-course at Debre Tabor General Hospital, northwest Ethiopia: nine-years retrospective study

“…At the same time, our findings are from one site, while the national data is countrywide and thus disparity is likely. However, similar findings to the present study have also been reported by other studies conducted in Ethiopia [28][29][30].…”

Outcome of tuberculosis treatment and its predictors among HIV infected patients in southwest Ethiopia

“…This result is unsatisfactory when compared with the WHO report, where 73% of TB/HIV co-infected patients globally, and 75% in Africa achieved successful treatment 12. The success rate of this study is a lot lower than previous works in resource limited countries 14–16,18. The low rate of successful treatment outcomes found in our study might be partly due to the high rate of transferred patients (46.3%), where treatment outcomes of those patients were not recorded in the facility where they started the treatment.…”

“…The high rate of mortality in this study might be partly due to improper selection of anti-TB medication in patients who had a prior history of TB treatment where a five-drug combination must be used,11 while in the study area among patients who were candidates for rifampicin, isoniazid, ethambutol, pyrazinamide, and streptomycin, five patients received rifampicin, isoniazid, ethambutol, and pyrazinamide instead. Previously conducted studies showed varying results with regard to mortality of TB/HIV co-infected patients, ranging from 1.8% to 29% 14–16,18,23,27. Mortality is different with geographical location and the year at which the studies were conducted.…”

Study of treatment outcome of tuberculosis among HIV co-infected patients: a cross sectional study in Aurangabad city, Maharashtra

“…13 In the study of Ali et al out of the total TB patients enrolled in the study, proportion of HIV non-infected patients were higher to that of HIV co-infected. 16 In our study the prevalence of TB-HIV co-infection is found to be 7.28%. They found that, treatment success rate was somewhat lower i.e.…”