Tuberculosis case fatality rates in high HIV prevalence populations in sub-Saharan Africa

Mukadi, Ya Diul; Maher, Dermot; Harries, Anthony

doi:10.1097/00002030-200101260-00002

Cited by 248 publications

(190 citation statements)

References 36 publications

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“…Co-infected patients are also more likely to die from TB, which is more easily curable in HIV-negative patients. [1] The rate of unfavourable treatment outcome for HIV-positive pulmonary TB patients in some African countries is now as high as 20% for sputum smear-positive cases and 50% for sputum smear-negative cases. [2,3] Deaths from TB represent a significant indicator of the severity of the effect of HIV on TB epidemiology.…”

Section: Researchmentioning

confidence: 99%

“…[2,3] Deaths from TB represent a significant indicator of the severity of the effect of HIV on TB epidemiology. [1] Extrapulmonary TB (EPTB), which is also a risk factor for unfavourable outcome, is 20 -70% more common in HIV-positive patients. [4] In 2013, there were 1.5 million deaths from TB globally, 360 000 of them associated with HIV.…”

Section: Researchmentioning

confidence: 99%

“…This may have an adverse influence on the willingness of individuals suspected of having TB to come forward for diagnosis and complete TB treatment. [1] According to South African (SA) data, TB was the leading cause of death in persons 15 -24 years of age in 2010, accounting for 14% of all deaths. [9] In 2013, the World Health Organization (WHO) reported that 62% of TB patients in SA were co-infected with HIV.…”

Section: Researchmentioning

confidence: 99%

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Influence of HIV and other risk factors on tuberculosis

Mahtab

Coetzee

2017

S Afr Med J

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Background. Tuberculosis (TB) notification in South Africa has increased six-fold over the past two decades, mainly because of the HIV epidemic. Objectives. To describe the sociodemographic and outcome characteristics of TB patients, and to identify risk factors associated with TB treatment outcomes stratified by HIV status. Methods. A cross-sectional study was used to analyse data from the Cape Town Metro East geographical service area (GSA) electronic TB register (ETR.Net), including adult patients aged ≥15 years who initiated TB treatment between 1 July 2011 and 30 June 2012. Results. TB case notification in the GSA was 922 per 100 000 population. Of the 12 672 TB patients registered, 50.5% were co-infected with HIV. The death rate in co-infected patients was 5.4% v. 2.8% in HIV-negative patients, the rate of treatment success 66.6% v. 73.5%, and the rate of unfavourable treatment outcome 28.1% v. 23.7%. The Khayelitsha subdistrict had the highest proportion of TB burden (37.0%) and co-infection (47.6%). Fourteen percent of patients had extrapulmonary TB, 65.9% of whom were co-infected with HIV. In the multivariate analysis, HIV infection (relative risk (RR) 1.2), retreatment (RR 1.4) and sputum smear microscopy not done (RR 1.4) were significantly associated with unfavourable treatment outcome. The Eastern (RR 0.9) and Northern (RR 0.7) subdistricts were less likely to have unfavourable outcomes compared with Khayelitsha. In the stratified analysis, retreatment and smear not done were significant risk factors for an unfavourable treatment outcome in both co-infected and HIV-negative patients. Conclusions. The burdens of both TB and co-infection were high in this community, although HIV prevalence varied. Mortality was higher and treatment completion lower in co-infected patients than in those who were HIV-negative. Co-infection, previous TB treatment and smear not done were significant risk factors for an unfavourable outcome in all patients.

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Section: Researchmentioning

confidence: 99%

Section: Researchmentioning

confidence: 99%

Section: Researchmentioning

confidence: 99%

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Influence of HIV and other risk factors on tuberculosis

Mahtab

Coetzee

2017

S Afr Med J

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“…Autopsies are not routinely performed in HIV-infected persons in Asia, and data from Africa may not be generalizable to Asia. Malaria is much less common in Asia than in Africa, and HIV-infected TB patients have more severe immunosuppression and higher death rates than patients in Africa (2)(3)(4)(6)(7)(8)(9)(14)(15)(16)(17)(18)(19). Understanding actual causes of death may help with identifying effective interventions.…”

mentioning

confidence: 99%

Causes of Death in HIV-infected Persons Who Have Tuberculosis, Thailand

Cain¹,

Anekthananon²,

Burapat³

et al. 2009

Emerg. Infect. Dis.

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Up to 50% of persons with HIV and a diagnosis of tuberculosis (TB) in Thailand die during TB treatment. In a prospective observational study, a team of physicians ascribed the cause of death after reviewing verbal autopsies (interviews of family members about events preceding death), laboratory data, and medical records. Of 849 HIVinfected TB patients enrolled, 142 (17%) died. The cause of death was TB for 38 (27%), including 6 with multidrugresistant TB and 20 with disseminated TB; an HIV-associated condition other than TB for 50 (35%); and a condition unrelated to TB or HIV for 22 (15%). Twenty-three patients (16%) were judged not to have had TB at all. Death from all causes except those unrelated to TB or HIV was less common in persons receiving antiretroviral therapy (ART). In addition to increasing the use of ART, death rates may be reduced through expanded use of modern TB diagnostic techniques.

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“…1 In addition, there is significant mortality from TB infection in HIV infected persons. 3 It is therefore important to identify additional factors associated with recurrent TB in the HIV-infected population to aid in the development of efficient risk-reduction interventions. The aim of this study was to conduct a systematic review of the published literature in order to identify additional risk factors for recurrent TB infection in people living with HIV/AIDS in Africa.…”

Section: Introductionmentioning

confidence: 99%

A systematic review of published literature describing factors associated with tuberculosis recurrence in people living with HIV in Africa

Moodley

Govender

2016

Afr H. Sci.

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Background: A summary of factors associated with recurrent tuberculosis (TB) in the African HIV-infected population is lacking. We performed a systematic review to address this. Methods: We performed a literature search within PubMed and The WHO Global Library with specific inclusion and exclusion criteria to identify manuscripts emanating from the African continent which potentially described factors associated with recurrent TB in persons living with HIV. Results: The literature search yielded 52 unique manuscripts, of which only 4 manuscripts were included in the final systematic review following application of the inclusion and exclusion criteria. Baseline CD4 count, baseline HIV viral load, a positive tuberculin skin test, prior active TB disease, cutaneous hypersensitivity reaction to treatment, having < 3 lung zones affected by prior TB disease, and anaemia were associated with recurrent TB in HIV-infected individuals, whilst age and antiretroviral status were not. Conclusion:The lack of studies describing recurrent TB in Africa which stratify results by HIV-status is a hindrance to understanding risk factors for recurrent TB in this population. This might be overcome by implementing guidelines related to the publishing of data from observational studies in peer-reviewed medical journals reporting recurrent TB in populations with a high-burden of HIV infection.

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Tuberculosis case fatality rates in high HIV prevalence populations in sub-Saharan Africa

Cited by 248 publications

References 36 publications

Influence of HIV and other risk factors on tuberculosis

Influence of HIV and other risk factors on tuberculosis

Causes of Death in HIV-infected Persons Who Have Tuberculosis, Thailand

A systematic review of published literature describing factors associated with tuberculosis recurrence in people living with HIV in Africa

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