Tuberculosis Treatment Outcome in Patients with Tb-hiv Co-infection in Kuala Lumpur, Malaysia

Abstract

Background: Tuberculosis (TB) is a serious health threat to people living with human immunodeficiency virus (HIV). Directly observed treatment, short course (DOTS) is one of many efforts done as part of ending TB, in which all confirmed TB sputum smear positive cases properly given treatment and monitored by the healthcare providers or family members to ensure treatment adherence. This study aimed to identify the characteristics, to determine the rate of unsuccessful TB treatment rate and to determine determinants of unsuccessful TB treatment outcome among patients with TB-HIV co-infection in Kuala Lumpur.Methods: This was a cross-sectional study. The data of all patients with TB-HIV co-infection in the federal territory of Kuala Lumpur from 2013 to 2017 were collected and reviewed. The data were retrieved from the national database (TB Information System) at the Kuala Lumpur Health Department from 1 March 2018 to 31 May 2018.Results: Out of 235 randomly selected patients with TB-HIV co-infection, TB treatment outcome was successful in 57.9% (cured and completed treatment) and unsuccessful in 42.1% (died, failed or defaulted treatment). Patients who did not receive DOTS (adjusted odds ratio [aOR] 21.71; 95% confidence interval [CI]: 5.36–87.94) and those who received shorter treatment duration of <6 months (aOR 34.54; 95% CI: 5.97–199.93) had higher odds for unsuccessful TB treatment outcome.Conclusions: Nearly half of the patients with TB-HIV co-infection had unsuccessful TB treatment outcome. Therefore, it is important to ensure that such patients receive DOTS and continuous TB treatment of >6 months. It is crucial to strengthen and widen the coverage of DOTS, especially among high-risk groups, in healthcare settings. Strict follow-up by healthcare providers is needed for patients with TB-HIV co-infection to gain treatment adherence and for better rates of successful TB treatment.