Blog
About

16
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

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

      Read this article at

      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Background

          Co-infection with HIV challenges treatment of tuberculosis (TB) and worsens the outcome. This study aimed to assess the outcome of TB treatment and its predictors among HIV infected patients at Mizan-Tepi University Teaching Hospital (MTUTH), Ethiopia.

          Methods

          Medical records of 188 TB/HIV co-infected patients who attended the TB clinic of MTUTH from September 2012 to December 2015 were reviewed from March 14 to April 1, 2016. The primary endpoints of the study were treatment outcome of TB and its predictors. Data were analyzed by Statistical Package for Social Sciences version 21. Multivariable binary logistic regression analysis was carried out to identify predictors of treatment outcome. Statistical significance was considered at p-value <0.05.

          Result

          The treatment outcomes of TB patients included in this study were 18 (9.57%) cured, 20 (10.64%) defaulted, 24 (12.77%) died, 39 (20.74%) completed the treatment, and 87 (46.28%) transferred out. A successful treatment outcome was achieved in 57 (30.32%) patients. Initial World Health Organization (WHO) clinical stage III (COR: 2.60; 95%CI: 1.17–5.76) and stage IV (COR: 4.00; 95%CI: 1.29–12.40) were associated with unfavorable outcome. Both WHO stages (III, IV) at the time of HIV diagnosis were independent predictors of poor treatment outcome (AOR: 3.08; 95%CI: 1.14–8.38; AOR: 5.80; 95%CI: 1.36–24.71 respectively). However, smear positive TB was an independent predictor of a favorable treatment outcome (AOR: 2.50; 95%CI: 1.13–5.51).

          Conclusion

          This study revealed that treatment outcome of TB patients was unsatisfactory, which signals a need for improved care. Advanced WHO clinical stages were predictors of poor outcome, while smear positive TB favors good outcome.

          Related collections

          Most cited references 24

          • Record: found
          • Abstract: found
          • Article: found
          Is Open Access

          Tuberculosis and HIV Co-Infection

          Tuberculosis (TB) and HIV co-infections place an immense burden on health care systems and pose particular diagnostic and therapeutic challenges. Infection with HIV is the most powerful known risk factor predisposing for Mycobacterium tuberculosis infection and progression to active disease, which increases the risk of latent TB reactivation 20-fold. TB is also the most common cause of AIDS-related death. Thus, M. tuberculosis and HIV act in synergy, accelerating the decline of immunological functions and leading to subsequent death if untreated. The mechanisms behind the breakdown of the immune defense of the co-infected individual are not well known. The aim of this review is to highlight immunological events that may accelerate the development of one of the two diseases in the presence of the co-infecting organism. We also review possible animal models for studies of the interaction of the two pathogens, and describe gaps in knowledge and needs for future studies to develop preventive measures against the two diseases.
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Short-term and long-term risk of tuberculosis associated with CD4 cell recovery during antiretroviral therapy in South Africa.

            To determine the short-term and long-term risks of tuberculosis (TB) associated with CD4 cell recovery during antiretroviral therapy (ART). Observational community-based ART cohort in South Africa. TB incidence was determined among patients (n = 1480) receiving ART for up to 4.5 years in a South African community-based service. Updated CD4 cell counts were measured 4-monthly. Person-time accrued within a range of CD4 cell count strata (CD4 cell strata) was calculated and used to derive CD4 cell-stratified TB rates. Factors associated with incident TB were identified using Poisson regression models. Two hundred and three cases of TB were diagnosed during 2785 person-years of observation (overall incidence, 7.3 cases/100 person-years). During person-time accrued within CD4 cell strata 0-100, 101-200, 201-300, 301-400, 401-500 and more than 500 cells/microl unadjusted TB incidence rates were 16.8, 9.3, 5.5, 4.6, 4.2 and 1.5 cases/100 person-years, respectively (P < 0.001). During early ART (first 4 months), adjusted TB rates among those with CD4 cell counts 0-200 cells/microl were 1.7-fold higher than during long-term ART (P = 0.026). Updated CD4 cell counts were the only patient characteristic independently associated with long-term TB risk. Updated CD4 cell counts were the dominant predictor of TB risk during ART in this low-resource setting. Among those with baseline CD4 cell counts less than 200 cells/microl, the excess adjusted risk of TB during early ART was consistent with 'unmasking' of disease missed at baseline screening. TB incidence rates at CD4 cell counts of 200-500 cells/microl remained high and adjunctive interventions are required. TB prevention would be improved by ART policies that minimized the time patients spend with CD4 cell counts below a threshold of 500 cells/microl.
              Bookmark
              • Record: found
              • Abstract: not found
              • Article: not found

              Global tuberculosis control: surveillance, planning, financing

                Bookmark

                Author and article information

                Journal
                Int J Gen Med
                Int J Gen Med
                International Journal of General Medicine
                International Journal of General Medicine
                Dove Medical Press
                1178-7074
                2017
                06 June 2017
                : 10
                : 161-169
                Affiliations
                Department of Pharmacy, College of Health Sciences, Mizan-Tepi University, Mizan Aman, Ethiopia
                Author notes
                Correspondence: Adane Teshome Kefale, Department of Pharmacy, College of Health Sciences, Mizan-Tepi University, PO Box 260, Mizan Aman, Ethiopia, Tel +251 92 146 5244, Email adanet2011@ 123456gmail.com
                Article
                ijgm-10-161
                10.2147/IJGM.S135305
                5473492
                © 2017 Teshome Kefale and Anagaw. This work is published and licensed by Dove Medical Press Limited

                The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.

                Categories
                Original Research

                Medicine

                ethiopia, mtuth, tb/hiv co-infection, tb treatment outcome

                Comments

                Comment on this article