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Shaik RA, Holyachi SK, Ahmad MS, Miraj M, Alzahrani M, Ahmad RK, Almehmadi BA, Aljulifi MZ, Alzahrani MA, Alharbi MB, Ahmed MM. Clinico-demographic and survival profile of people living with HIV on antiretroviral treatment. Front Public Health 2023; 11:1084210. [PMID: 37064669 PMCID: PMC10098347 DOI: 10.3389/fpubh.2023.1084210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Accepted: 01/11/2023] [Indexed: 04/03/2023] Open
Abstract
Objective To assess the demographic, clinical, and survival profile of people living with HIV. Methods A retrospective cohort study was conducted among patients enrolled at a single antiretroviral therapy center in North Karnataka. A total of 11,099 were recruited from April 2007 to January 2020, out of which 3,676 were excluded and the final 7,423 entries were subjected to analysis. The outcome of interest was the time to death in months of people living with HIV on antiretroviral therapy (ART). The clinical and demographic characteristics were examined as potential risk factors for survival analysis. To investigate the factors that influence the mortality of patients using ART, univariate and multivariate Cox regression were performed. Hazard ratio (HR), 95% confidence interval (CI), and p-values were presented to show the significance. The log-rank test was used to determine the significance of the Kaplan-Meier survival curve. Results Out of 7,423 HIV-positive people, majority were female (51.4%), heterosexual typology (89.2%), and in the age group 31-45 years (45.5%). The risk of death in male patients was 1.24 times higher (95% CI: 1.14-1.35) than female patients. Patients with age >45 were 1.67 times more likely to die than patients ≤30 (95% CI: 1.50-1.91). In the multivariable analysis, the hazards of mortality increased by 3.11 times (95% CI: 2.09-2.79) in patients with baseline CD4 count ≤50 as compared to those who had baseline CD4 count >200. The risk of death in patients who were diagnosed with TB was 1.30 times more (95% CI: 1.19-1.42) than in those who did not have TB. The survival probabilities at 3 and 90 months were more in female patients (93%, 70%) compared with male patients (89, 54%), respectively. Conclusion This study proved that age, sex, baseline CD4 count, and tuberculosis (TB) status act as risk factors for mortality among people with HIV. Prevention strategies, control measures, and program planning should be done based on the sociodemographic determinants of mortality.
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Affiliation(s)
- Riyaz Ahamed Shaik
- Department of Family and Community Medicine, College of Medicine, Majmaah University, Al Majma'ah, Saudi Arabia
| | - Sharan K. Holyachi
- Department of Community Medicine, Koppal Institute of Medical Sciences, Koppal, Karnataka, India
| | - Mohammad S. Ahmad
- Department of Family and Community Medicine, College of Medicine, Majmaah University, Al Majma'ah, Saudi Arabia
| | - Mohammed Miraj
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Majmaah University, Al Majma'ah, Saudi Arabia
| | - Mansour Alzahrani
- Department of Family and Community Medicine, College of Medicine, Majmaah University, Al Majma'ah, Saudi Arabia
| | - Ritu Kumar Ahmad
- Department of Physiotherapy, College of Applied Medical Science, Buraydah Private Colleges, Buraydah, Saudi Arabia
| | - Bader A. Almehmadi
- Department of Medicine, College of Medicine, Majmaah University, Al Majma'ah, Saudi Arabia
| | - Mohammed Zaid Aljulifi
- Department of Family and Community Medicine, College of Medicine, Majmaah University, Al Majma'ah, Saudi Arabia
| | - Meshari A. Alzahrani
- Department of Urology, College of Medicine, Majmaah University, Al Majma'ah, Saudi Arabia
| | | | - Mohammed Muzammil Ahmed
- Department of Basic Medical Sciences, College of Medicine, Majmaah University, Al Majma'ah, Saudi Arabia
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Osei Bonsu E, Addo IY, Adjei BN, Alhassan MM, Nakua EK. Prevalence, treatment outcomes and determinants of TB-HIV coinfection: a 10-year retrospective review of TB registry in Kwabre East Municipality of Ghana. BMJ Open 2023; 13:e067613. [PMID: 36948553 PMCID: PMC10040042 DOI: 10.1136/bmjopen-2022-067613] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/24/2023] Open
Abstract
OBJECTIVE To assess the prevalence, treatment outcomes and determinants of tuberculosis (TB)-HIV coinfection in Ghana. STUDY DESIGN A retrospective review of TB case register for Kwabre East Municipality was conducted for the period 2010-2020 to identify TB-HIV coinfections. SETTING 462 patients with TB from four sub-municipal treatment centres were included in the study. PRIMARY OUTCOME MEASURE A logistic regression model was used to investigate the relationship between clinico-demographic factors (age, sex, type of patient, disease classification, treatment category and sputum smear microscopy) and TB-HIV coinfection. RESULTS Of the 462 individual TB cases found in the TB register from 2010 to 2020, 286 (61.9%) were screened for HIV and the results showed that 18% had TB-HIV coinfection. TB-HIV coinfection was highest in 2015 with a prevalence of 40% among all registered TB cases. The likelihood of TB-HIV coinfection was highest among patients with TB aged 40-49 years (AOR=3.99, CI=1.3, 12.7). Those who tested negative for TB at the end of their treatment period had lower odds of HIV coinfection (AOR=0.27, CI=0.10, 0.72). CONCLUSION Nearly one out of every five (18%) patients with TB in the municipality were found to be coinfected with HIV. TB-HIV coinfection was significantly associated with patients' age and their TB treatment outcomes. Urgent interventions are needed to address these risk factors to promote optimal health for patients with TB in the municipality.
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Affiliation(s)
- Emmanuel Osei Bonsu
- Department of Epidemiology and Biostatistics, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- Department of Public Health, Ghana Health Service, Accra, Ghana
| | - Isaac Yeboah Addo
- Centre for Social Research in Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Benjamin Noble Adjei
- Department of Epidemiology and Biostatistics, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Muhib Mohammed Alhassan
- Department of Epidemiology and Biostatistics, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Emmanuel Kweku Nakua
- School of Public Health, Department of Epidemiology and Biostatistics, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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Reis-Santos B, Locatelli R, Oliosi J, Sales CM, do Prado TN, Shete PB, Riley LW, Maciel EL. A Matter of Inclusion: A Cluster-Randomized Trial to Access the Effect of Food Vouchers Versus Traditional Treatment on Tuberculosis Outcomes in Brazil. Am J Trop Med Hyg 2022; 107:1281-1287. [PMID: 36375455 PMCID: PMC9768270 DOI: 10.4269/ajtmh.21-1074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 08/10/2022] [Indexed: 11/16/2022] Open
Abstract
We assessed the effectiveness of food vouchers as a social protection strategy to enhance the adherence to tuberculosis treatment in health-care facilities in Brazil between 2014 and 2017. A cluster-randomized controlled trial was performed in four Brazilian capital cities. A total of 774 adults with newly diagnosed pulmonary tuberculosis were included in this study. Eligible participants initiated standard tuberculosis treatment per National Tuberculosis Program guidelines. Health clinics were assigned randomly to intervention groups (food voucher or standard treatment). The food voucher was provided by researchers, which could be used by subjects only for buying food. Most people with tuberculosis were poor, did receive benefits of the Bolsa Familia Program, and were unemployed. By Poisson regression analysis, with the total number of subjects included in the study, we found that individuals with tuberculosis who received food vouchers had a 1.13 greater risk of cure (95% CI, 1.03-1.21) compared with those who did not receive food vouchers. The provision of food vouchers improved outcomes of tuberculosis treatment and it should be enhanced even further as social protection for people with tuberculosis.
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Affiliation(s)
- Barbara Reis-Santos
- Laboratory of Epidemiology of Federal University of Espírito Santo, Maruípe, Vitória, Espírito Santo, Brazil
| | - Rodrigo Locatelli
- Laboratory of Epidemiology of Federal University of Espírito Santo, Maruípe, Vitória, Espírito Santo, Brazil
| | - Janaína Oliosi
- Laboratory of Epidemiology of Federal University of Espírito Santo, Maruípe, Vitória, Espírito Santo, Brazil
| | - Carolina M. Sales
- Laboratory of Epidemiology of Federal University of Espírito Santo, Maruípe, Vitória, Espírito Santo, Brazil
| | - Thiago Nascimento do Prado
- Laboratory of Epidemiology of Federal University of Espírito Santo, Maruípe, Vitória, Espírito Santo, Brazil
| | - Priya B. Shete
- Division of Pulmonary and Critical Care Medicine and Center for Tuberculosis, San Francisco, California
- University of California, San Francisco, California
| | - Lee W. Riley
- Division of Infectious Diseases and Vaccinology, School of Public Health, University of California, Berkeley, California
| | - Ethel L. Maciel
- Laboratory of Epidemiology of Federal University of Espírito Santo, Maruípe, Vitória, Espírito Santo, Brazil
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Yang N, Chen C, He J, Li J, Zhong Y. Treatment outcome and its associated factors among HIV-MTB co-infected patients in Sichuan, China: A retrospective study. Medicine (Baltimore) 2022; 101:e32006. [PMID: 36482608 PMCID: PMC9726276 DOI: 10.1097/md.0000000000032006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 11/03/2022] [Indexed: 12/13/2022] Open
Abstract
Human immunodeficiency virus (HIV)-Mycobacterium tuberculosis (MTB) co-infection has become a pressing global public health problem. Although tuberculosis (TB) is both treatable and curable, it has been exacerbated by the HIV/acquired immune deficiency syndrome (AIDS) epidemic. HIV-MTB co-infected patients have a variety of disease-specific, and treatment-related factors that can adversely affect their treatment outcomes. This study was conducted to assess the outcomes of TB treatment and its associated factors among HIV-MTB co-infected patients in Sichuan, Southwest China. A retrospective study was performed on HIV-MTB co-infected patients who were diagnosed and registered in TB designated hospitals in Sichuan from January 1, 2016, to December 31, 2020. Data were collected from patients' electronic medical records regarding their demographic, clinical, and social support information, and categorical data, such as sex, were reported using numbers and percentages. χ2 and t-tests were conducted to compare groups in relation to different levels of medical institutions. A binary logistic regression model was used to identify the factors associated with unsuccessful TB treatment outcomes. For logistic regression analysis performed using an α of 0.05, odds ratios (ORs) and corresponding 95% confidence intervals (CIs) were calculated for various risk factors. A total of 3677 registered HIV-MTB co-infected patients were enrolled. After adjusting for other variables, male, advanced age, receiving TB treatment at the municipal medical institution, being diagnosed with external pulmonary TB, referral or tracing, being sputum smear positive, not initiating antiretroviral therapy (ART) and not using fixed-dose combinations were the main risk factors for treatment failure of HIV-MTB co-infected patients in Sichuan province. Sex, age, hospital level, patient source, other diagnostic factors (e.g., sputum smear results, anatomical site of TB), and factors of therapeutic schemes (e.g., antiretroviral therapy, fixed-dose combinations) may serve as risk factors to estimate the likely treatment outcome of HIV-TB co-infection.
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Affiliation(s)
- Ni Yang
- Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan, China
| | - Chuang Chen
- Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan, China
| | - Jinge He
- Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan, China
| | - Jing Li
- Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan, China
| | - Yin Zhong
- Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan, China
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Fenta A, Demeke G, Bitew A, Kebede D, Hailu T. Prevalence and Associated Factors of TB Co-Morbidity Among HIV Sero-Positive Individuals in Shegaw Motta District Hospital, Ethiopia. Int J Gen Med 2020; 13:1529-1536. [PMID: 33364814 PMCID: PMC7751771 DOI: 10.2147/ijgm.s278758] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 11/24/2020] [Indexed: 11/26/2022] Open
Abstract
Background Tuberculosis (TB) is a major public health problem among people living with Human Immunodeficiency Virus (HIV) in resource-limited countries like Ethiopia. Up-to-date information regarding TB co-morbidity and determinant factors among HIV sero-positive individuals is lacking in the study area. Objective This study aimed to determine the prevalence of TB co-morbidity and their determinants among HIV sero-positive individuals in Shegaw Motta district hospital. Methods A cross-sectional study was conducted among 326 people living with HIV from February to April 2019, in Shegaw Motta district hospital. The systematic random sampling technique was used to select the study participants. Data were entered into the EpiData version 3.1 and analysis was done using SPSS version 20.0. Results The prevalence of TB/HIV co-infection was 18.1%. TB/HIV patients whose drunk alcohol (AOR=2.36, 95% CI=1.07–5.19), BMI< 16 (AOR= 19.13, 95% CI=4.14–88.36), and BMI ranges between 16 and 18.5 (AOR=9.78, 95% CI=3.07–31.19), World Health Organization (WHO) clinical stage IV (AOR=23.02, 95% CI=3.76–140.97), WHO clinical stage III (AOR=14.36, 95% CI=3.50–58.92), and WHO clinical stage II (AOR=4.17, 95% CI=1.34–13.01), bedridden (AOR=13.79, 95% CI=5.44–34.95) and ambulatory functional status (AOR=5.30, 95% CI=1.87–15.05) were significant predictors for TB/HIV co-infection. Conclusion The prevalence of TB among HIV sero-positive individuals is high. Determinant factors, including drinking alcohol, BMI, WHO clinical stage and functional status, were significant predictors for TB/HIV co-infections. Therefore, diagnosis of TB among sero-positive individuals should be strengthened in health institutions.
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Affiliation(s)
- Abebe Fenta
- Health Science College, Debremarkos University, Debre Markos, Ethiopia
| | | | - Abebaw Bitew
- Health Science College, Debremarkos University, Debre Markos, Ethiopia
| | | | - Tadesse Hailu
- College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
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Cavalin RF, Pellini ACG, Lemos RRGD, Sato APS. TB-HIV co-infection: spatial and temporal distribution in the largest Brazilian metropolis. Rev Saude Publica 2020; 54:e112. [PMID: 33146301 PMCID: PMC7593020 DOI: 10.11606/s1518-8787.2020054002108] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Accepted: 05/03/2020] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVE To describe the spatial and temporal distribution of TB-HIV co-infection, as well as the profile of the characteristics of the co-infected population in the municipality of São Paulo. METHODS This is an ecological and time series study with data from the Tuberculosis Patient Control System (TBWeb), including all new cases of tuberculosis co-infected individuals with HIV living in the municipality from 2007 to 2015. Time trends of the disease were analyzed using Prais-Winsten regression. The cases were geocoded by the address of residence for the elaboration of maps with the incidence rates smoothed by the local empirical Bayesian method. The global and local Moran indexes evaluated spatial autocorrelation. Individuals' profiles were described and the characteristics of the cases with and without fixed residence were compared by Pearson's chi-square or Fisher's exact tests. RESULTS We analyzed 6,092 new cases of TB-HIV co-infection (5,609 with fixed residence and 483 without fixed residence). The proportion of TB-HIV co-infection ranged from 10.5% to 13.7%, with a drop of 3.0% per year (95%CI -3.4 - -2.6) and was higher in individuals without fixed residence. Incidence rates decreased by 3.6% per year (95%CI -4.4% - -2.7%), declining from 7.0 to 5.3 per 100,000 inhabitants/year. Co-infection showed positive and significant spatial autocorrelation, with heterogeneous spatial pattern and a high-risk cluster in the central region of the municipality. Cure was achieved in 55.5% of cases with fixed residence and in 32.7% of those without a fixed residence. CONCLUSIONS The data indicate an important advance in the control of TB-HIV co-infection in the period analyzed. However, we identified areas and populations that were unequally affected by the disease and that should be prioritized in the improvement of actions to prevent and control co-infection.
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Affiliation(s)
- Roberta Figueiredo Cavalin
- Universidade de São Paulo . Faculdade de Saúde Pública . Programa de Pós-Graduação em Saúde Pública . São Paulo , SP , Brasil
| | | | - Regina Rocha Gomes de Lemos
- Secretaria Municipal da Saúde . Coordenação de Vigilância em Saúde de São Paulo . Programa Municipal de Controle da Tuberculose . São Paulo , SP , Brasil
| | - Ana Paula Sayuri Sato
- Universidade de São Paulo . Faculdade de Saúde Pública . Departamento de Epidemiologia . São Paulo , SP , Brasil
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Predictors of Adverse TB Treatment Outcome among TB/HIV Patients Compared with Non-HIV Patients in the Greater Accra Regional Hospital from 2008 to 2016. Tuberc Res Treat 2020; 2020:1097581. [PMID: 32832153 PMCID: PMC7424490 DOI: 10.1155/2020/1097581] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 07/13/2020] [Indexed: 11/26/2022] Open
Abstract
Introduction The convergence of TB and HIV dual epidemics is a major public health challenge in Ghana as well as many developing countries. Treatment outcome monitoring is a vital part of the surveillance needed to successfully eliminate TB. The impact of HIV status and demographic and treatment-related factors on adverse TB treatment outcome has not been studied in the Greater Accra Regional Hospital. This study determined factors associated with TB treatment outcome in patients with TB-HIV coinfection and TB-only infection in the hospital. Method A cross-sectional study was carried out in the Greater Accra Regional Hospital. We reviewed TB treatment cards of patients who received treatment for tuberculosis in the hospital from 2008 to 2016. Data on treatment outcome and sociodemographic and clinical characteristics were extracted on TB-only-infected and TB/HIV-coinfected patients. The chi-squared test and binary and multiple logistic regression models were used to assess factors associated with adverse treatment outcome. Results Out of the 758 patient records analyzed, 174 (22.9%) were TB-HIV-coinfected patients. Overall treatment success for all TB patients was 88.1% (668/758). About 11.9% (90/758) of the patients had an adverse treatment outcome, including treatment failure 0.9% (7/758), defaulting 0.9% (7/758), and death 10.0% (76/758). TB-HIV-coinfected patients' treatment success was 78.1% (136/174). TB-only patients' treatment success was 91.4% (532/582). Independent predictors of adverse treatment outcome were found to be as follows: being HIV positive (aOR: 3.85, 95% CI: 2.19-6.75; p < 0.01); aged 65 and above (aOR: 1.76, 95% CI: 1.44-1.54; p = 0.01); and previously failed TB treatment (aOR: 5.02, 95% CI: 2.09-28.87; p < 0.01). Conclusion Treatment outcome for TB-HIV-coinfected patients is below the WHO target. HIV status, age, and category of patient of the TB patients were associated with adverse treatment outcome. Strengthening the TB/HIV collaborative efforts by stakeholders is required for good treatment outcomes.
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Bastos SH, Taminato M, Fernandes H, Figueiredo TMRMD, Nichiata LYI, Hino P. Sociodemographic and health profile of TB/HIV co-infection in Brazil: a systematic review. Rev Bras Enferm 2019; 72:1389-1396. [PMID: 31531666 DOI: 10.1590/0034-7167-2018-0285] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Accepted: 11/29/2018] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE to ascertain the epidemiological profile of TB/HIV co-infection in Brazilian scenarios. METHOD this is a systematic review conducted via electronic search in databases PubMed, EMBASE, LILACS and SciELO, having as inclusion criterion articles based on the Brazilian scenario of TB/HIV co-infection. RESULTS of the total 174 studies, 15 were selected, revealing the epidemiological profile of the co-infection in different scenarios: male, economically active age, low education level, brown/black ethnicity, low income, heterosexual, pulmonary clinical form, alcoholism and Directly Observed Therapy. CONCLUSION the sociodemographic and epidemiological profile of people with TB/HIV co-infection has an expected occurrence pattern, which corroborates articles found in the literature, either at national level or by grouping the studies according to region or state.
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Affiliation(s)
| | - Mônica Taminato
- Universidade Federal de São Paulo. São Paulo, São Paulo, Brazil
| | - Hugo Fernandes
- Universidade Federal de São Paulo. São Paulo, São Paulo, Brazil
| | | | | | - Paula Hino
- Universidade Federal de São Paulo. São Paulo, São Paulo, Brazil
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Tanue EA, Nsagha DS, Njamen TN, Assob NJC. Tuberculosis treatment outcome and its associated factors among people living with HIV and AIDS in Fako Division of Cameroon. PLoS One 2019; 14:e0218800. [PMID: 31361755 PMCID: PMC6667204 DOI: 10.1371/journal.pone.0218800] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2018] [Accepted: 06/10/2019] [Indexed: 11/18/2022] Open
Abstract
Background Tuberculosis (TB) and HIV co-infection challenges treatment and worsens the outcome of TB treatment. This study aimed to assess the outcome of TB treatment and factors facilitating treatment success among people living with HIV/AIDS in Fako Division of the South West Region of Cameroon. Methods A hospital-based retrospective cohort study was conducted by manually reviewing medical records of HIV/TB co-infected patients from January 2010 to September 2017. A structured data collection form was used to review the medical records of HIV patients co-infected with TB aged 10 years and older. Patients with incomplete files were dropped from the study. Treatment success was defined as the sum of patients who were declared cured and those who had completed treatment, as per the World Health Organization’s recommendations. Data were analyzed using Statistical Package for Social Sciences version 21. Bivariate and multivariate logistic regression model was carried out to identify factors facilitating successful TB treatment outcome. Significance was obtained through adjusted odds ratio with its 95% confidence interval and a p<0.05. Results A total of 2,986 files were reviewed but 2,928 (98.1%) were retained. Out of the 2,928 medical files of adult TB patients reviewed, 1,041 (35.6%, [95% CI 33.8%-37.3%]) were HIV/TB co-infected. The 1,041 co-infected patients had a mean age of 37.07 (SD of10.02) years and 56.3% were females. The treatment outcome of TB patients were 795(76.4%) cured, 23(2.2%) treatment completed, 99(9.5%) were lost to follow-up, 16 (1.5%) failed, 72(6.9%) died and 36(3.5%) transferred out. A successful treatment outcome was achieved in 818(78.6%,[95% CI: 76.0%–81.0%]) patients. Being a female [COR 1.61, 95% CI: 1.19–2.17, p = 0.002], receiving TB treatment in 2014 [COR 2.00, 95% CI: 1.11–3.60, p = 0.021] and 2015 [COR 2.50, 95% CI: 1.39–4.50, p = 0.002], having relapsed TB infection [COR 0.46, 95% CI: 0.23–0.93, p = 0.031], receiving ART [COR 1.95, 95% CI: 1.28–2.97, p = 0.002] and Cotrimoxazole [COR 2.03, 95% CI: 1.12–3.66, p = 0.019] were factors significantly associated with successful treatment. After adjusting for confounders, successful treatment outcome were associated with being a female [AOR 1.6; 95% CI: 1.21–2.22, p = 0.001], diagnosis of TB in 2014 [AOR 1.90; 95% CI: 1.04–3.45, p = 0.036] and 2015 [AOR 2.43; 95% CI: 1.33–4.43, p = 0.004]. Conclusion There is a high TB treatment success rate among HIV/TB co-infected patients in our setting, although below the target set by the WHO. Specific interventions aimed at enhancing patient outcomes are recommended.
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Affiliation(s)
- Elvis Asangbeng Tanue
- Department of Public Health and Hygiene, Faculty of Health Sciences, University of Buea, Buea, Cameroon
| | - Dickson Shey Nsagha
- Department of Public Health and Hygiene, Faculty of Health Sciences, University of Buea, Buea, Cameroon
- * E-mail:
| | - Theophile Nana Njamen
- Department of Obstetrics and Gynecology, Faculty of Health Sciences, University of Buea, Buea, Cameroon
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Tuberculosis burden on AIDS in Brazil: A study using linked databases. PLoS One 2018; 13:e0207859. [PMID: 30462733 PMCID: PMC6249013 DOI: 10.1371/journal.pone.0207859] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Accepted: 11/07/2018] [Indexed: 12/28/2022] Open
Abstract
Objectives To estimate the burden of tuberculosis (TB) in reported AIDS cases, to compare the characteristics of TB/HIV subjects with those without TB and to evaluate survival with or without TB in Brazil. Methods The data source was the linked database between AIDS (2011–2014) and TB (2011–2014) databases from the Notifiable Diseases Information System (SINAN). The sociodemographic, clinical, laboratory results and use of antiretroviral therapy (ART) data were compared by TB occurrence or not. Survival probability was estimated using the Kaplan-Meier method and associated factors were sought using Cox regression. Results The proportion of TB diagnosed from 2011 to 2014 among AIDS cases reported between 2006 and 2014 was 6.3%. Subjects coinfected with TB were predominantly male, older, with lower schooling, with lower CD4 count, higher viral load, and higher proportion of ART initiation than those without TB. 57.5% were diagnosed with HIV before TB, 38.2% as concurrent TB/HIV and 4.3% with TB before HIV. 16,466 reported TB cases were not found in the AIDS database, although registered as HIV-infected in the SINAN TB database between 2011 and 2014. Median survival for PLHIV was 581 days, with 582 for those without TB, significantly higher than 547 for those with TB (log-rank teste, p = 0,001). In the Cox multivariate analysis, male gender [aHR = 1.27 (CI 95% 1.22–1.33)], older age [aHR = 1.020 (CI 95% 1.019–1.022)] and TB coinfection [aHR = 1.97 (CI 95% 1.88–2.07)] were positively associated with adjusted hazard of death, whereas CD4 count 200–499 cells [aHR = 0.21 (CI 95% 0.20–0.22)] and receiving ART [aHR = 0.2 2(CI 95% 0.21–0.23)] reduced the risk of death. Conclusions HIV-infected subjects should be screened for TB at care entry, to minimize diagnosis and treatment delays when active TB is present or to increase the odds of being offered latent TB infection therapy to prevent TB. On the other hand, TB cases should be promptly tested for HIV. All those will contribute to reduce mortality among people living with AIDS.
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Okonko IO, Anyanwu A, U Osadebe A, N Odu N. HIV and tuberculosis co-infection in a highly HIV-infected population of rivers state, Nigeria. J Immunoassay Immunochem 2018; 39:636-646. [PMID: 30296205 DOI: 10.1080/15321819.2018.1529681] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Human Immunodeficiency Virus (HIV) and tuberculosis (TB) are considered as key players in the global health scene. This study sought to determine the prevalence of TB among HIV-positive attendees of the Directly Observed Treatment of Short Course (DOTS) program at the military hospital in Port Harcourt. The association of HIV prevalence with gender and age as risk factors was also determined. A total of 200 patients aged 15-65 years were screened. Re-screening for HIV was done for confirmation. The overall prevalence for anti-TB antibodies amongst HIV-positive individuals was 14.0% (7.5% in males and 6.5% in females) while HIV prevalence following re-screening was 92%. It was observed that based on employment status and level of education, the highest HIV prevalence was seen in unemployed individuals and individuals with no formal education. The result showed that 29.9% of the HIV seropositives were males while 70.1% were females. Sex-related prevalence of HIV-TB coinfection within groups indicated significantly higher co-infection rates (P < 0.05) among males (23.1%) than females (9.6%). Age-related prevalence of HIV-TB coinfection within groups showed that co-infection was significantly greater (P < 0.05) in ages below 30 years (21.2%) than in their counterparts 30 years and above (9.6%). This study confirmed the presence of TB co-infections among HIV-positive individuals in Port Harcourt, Nigeria. Considering the role of TB in driving the HIV pandemic, it is imperative that HIV-positive patients are screened for TB infection regularly to reduce the scale of active HIV-TB co-infection.
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Affiliation(s)
- Iheanyi O Okonko
- a Department of Microbiology, Faculty of Science , University of Port Harcourt , Choba , Nigeria
| | - Amaoge Anyanwu
- b Department of Microbiology Technology , School of Science Laboratory Technology, University of Port Harcourt , Choba , Nigeria
| | - Anwuli U Osadebe
- a Department of Microbiology, Faculty of Science , University of Port Harcourt , Choba , Nigeria
| | - Ngozi N Odu
- a Department of Microbiology, Faculty of Science , University of Port Harcourt , Choba , Nigeria
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Tesfaye B, Alebel A, Gebrie A, Zegeye A, Tesema C, Kassie B. The twin epidemics: Prevalence of TB/HIV co-infection and its associated factors in Ethiopia; A systematic review and meta-analysis. PLoS One 2018; 13:e0203986. [PMID: 30281631 PMCID: PMC6169899 DOI: 10.1371/journal.pone.0203986] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2018] [Accepted: 09/02/2018] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Tuberculosis and HIV/AIDS are the major public health problems in many parts of the world particularly in resource limited countries like Ethiopia. Although studies have been conducted on the prevalence and associated factors of TB / HIV co-infection in Ethiopia, there is no comprehensive data on the magnitude and risk factors at a national and regional levels. Therefore, this review is aimed to summarize the prevalence of TB /HIV co-infection in Ethiopia using meta-analysis based on a systematic review of published articles & grey literatures. METHODS To conduct this systematic review and meta-analysis, major databases such as Pub Med, Google scholar, CINAHL, Africa Journals Online and Google were systematically searched using search terms. PRISMA guideline was followed in the study. Two authors extracted all necessary data using a standardized data extraction format, and analysis was done using STATA version 11. A Statistical heterogeneity across the studies was evaluated by using Cochran's Q test and I2 statistic. The pooled effect size was conducted in the form of prevalence and associations were measured using odds ratio. Moreover, the univariate meta regression was performed by considering the sample size to determine potential sources of heterogeneity. The Egger's weighted regression and Begg's rank correlation tests were used to assess potential publication biases. RESULTS This meta-analysis included 21 studies with a total of 12,980 participants. The pooled prevalence of TB / HIV Co-infection was 25.59% (95% CI (20.89%-30.29%). A significant association was found between low CD4 counts (OR: 3.53; 95% CI: 1.55, 8.06), advanced WHO stage (OR: 6.81; 95% CI: 3.91, 11.88) and TB/ HIV/AIDS Co-infection. CONCLUSION This finding revealed that the magnitude of TB /HIV co-infection in Ethiopia is increasing and deserves special attention. Low CD4 count and advanced WHO stage are contributing factors for dual infection. Establishing mechanisms such as Conducting surveillance to determine HIV burden among TB patients and TB burden among HIV patients, and intensifying the three I's (Intensive case finding, INH Preventive Therapy and Infection control) should be routine work of clinicians. Moreover, early screening & treatment should be provided to those patients with low CD4 count and advanced WHO stage.
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Affiliation(s)
- Bekele Tesfaye
- Department of Nursing, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Animut Alebel
- Department of Nursing, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Alemu Gebrie
- Department of Biomedical Science, College of medicine, Debre Markos University, Debre Markos, Ethiopia
| | - Abriham Zegeye
- Department of Biomedical Science, College of medicine, Debre Markos University, Debre Markos, Ethiopia
| | - Cheru Tesema
- Department of Public Health, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Bekalu Kassie
- Department of midwifery, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
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Gaspar RS, Nunes N, Nunes M, Rodrigues VP. Temporal analysis of reported cases of tuberculosis and of tuberculosis-HIV co-infection in Brazil between 2002 and 2012. J Bras Pneumol 2017; 42:416-422. [PMID: 28117471 PMCID: PMC5344089 DOI: 10.1590/s1806-37562016000000054] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Accepted: 07/07/2016] [Indexed: 11/30/2022] Open
Abstract
Objective: To investigate the reported cases of tuberculosis and of tuberculosis-HIV co-infection in Brazil between 2002 and 2012. Methods: This was an observational study based on secondary time series data collected from the Brazilian Case Registry Database for the 2002-2012 period. The incidence of tuberculosis was stratified by gender, age group, geographical region, and outcome, as was that of tuberculosis-HIV co-infection. Results: Nationally, the incidence of tuberculosis declined by 18%, whereas that of tuberculosis-HIV co-infection increased by 3.8%. There was an overall decrease in the incidence of tuberculosis, despite a significant increase in that of tuberculosis-HIV co-infection in women. The incidence of tuberculosis decreased only in the 0- to 9-year age bracket, remaining stable or increasing in the other age groups. The incidence of tuberculosis-HIV co-infection increased by 209% in the ≥ 60-year age bracket. The incidence of tuberculosis decreased in all geographical regions except the south, whereas that of tuberculosis-HIV co-infection increased by over 150% in the north and northeast. Regarding the outcomes, patients with tuberculosis-HIV co-infection, in comparison with patients infected with tuberculosis only, had a 48% lower chance of cure, a 50% greater risk of treatment nonadherence, and a 94% greater risk of death from tuberculosis. Conclusions: Our study shows that tuberculosis continues to be a relevant public health issue in Brazil, because the goals for the control and cure of the disease have yet to be achieved. In addition, the sharp increase in the incidence of tuberculosis-HIV co-infection in women, in the elderly, and in the northern/northeastern region reveals that the population of HIV-infected individuals is rapidly becoming more female, older, and more impoverished.
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Affiliation(s)
| | - Natália Nunes
- . Curso de Medicina, Universidade Federal do Maranhão, São Luís (MA) Brasil
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Osei E, Der J, Owusu R, Kofie P, Axame WK. The burden of HIV on Tuberculosis patients in the Volta region of Ghana from 2012 to 2015: implication for Tuberculosis control. BMC Infect Dis 2017; 17:504. [PMID: 28724359 PMCID: PMC5517831 DOI: 10.1186/s12879-017-2598-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Accepted: 07/10/2017] [Indexed: 11/12/2022] Open
Abstract
Background The impact of HIV on TB, and the implications for TB control, has been acknowledged as a public health challenge. It is imperative therefore to assess the burden of HIV on TB patients as an indicator for monitoring the control efforts of the two diseases in this part of the world. This study aimed at determining the burden of HIV infection in TB patients. Methods We conducted a retrospective review of TB registers in five districts of the Volta Region of Ghana. Prevalence of TB/HIV co-infection was determined. Bivariate and multivariate logistic regression were used to identify the predictors of HIV infection among TB patients and statistical significance was set at p-value <0.05. Results Of the 1772 TB patients, 1633 (92.2%) were tested for HIV. The overall prevalence of TB/HIV co-infection was (18.2%; 95% CI: 16.4–20.1). The prevalence was significantly higher among females (24.1%; 95%CI: 20.8–27.7), compared to males (15.1%; 95% CI: 13.1–17.4) (p < 0.001) and among children <15 years of age (27.0%; 95% CI: 18.2–38.1), compared to the elderly ≥70 years (3.5%; 95% CI: 1.6–7.4) (p < 0.001). Treatment success rate was higher among patients with only TB (90%; 95% CI: 88.1–91.5) than among TB/HIV co-infected patients (77.0%; 95% CI: 71.7–81.7) (p < 0.001). Independent predictors of HIV infection were found to be: being female (AOR: 1.79; 95% CI: 1.38–2.13; p < 0.001); smear negative pulmonary TB (AOR: 1.84; 95% CI: 1.37–2.47; p < 0.001); and patients registered in Hohoe, Kadjebi, and Kpando districts with adjusted odds ratios of 1.69 (95% CI: 1.13–2.54; p = 0.011), 2.29 (95% CI: 1.46–3.57; p < 0.001), and 2.15 (95% CI: 1.44–3.21; p < 0.001) respectively. Patients ≥70 years of age and those registered in Keta Municipal were less likely to be HIV positive with odds ratios of 0.09 (95% CI: 0.04–0.26; p < 0.001) and 0.62 (95% CI: 0.38–0.99; p = 0.047) respectively. Conclusion TB/HIV co-infection rate in five study districts of the Volta region is quite high, occurs more frequently in female patients than males; among smear negative pulmonary TB patients, and children <15 years of age. Findings also demonstrate that HIV co-infection affects TB treatment outcomes adversely. Strengthening the TB/HIV collaborative efforts is required in order to reduce the burden of co-infection in patients.
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Affiliation(s)
- Eric Osei
- Department of Population and Behavioural Sciences, School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana.
| | - Joyce Der
- Department of Epidemiology and Biostatistics, School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
| | - Richard Owusu
- Department of Epidemiology and Biostatistics, School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
| | - Philip Kofie
- Department of Family and Community Health, School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
| | - Wisdom Kudzo Axame
- Department of Epidemiology and Biostatistics, School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
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Teshome Kefale A, Anagaw YK. Outcome of tuberculosis treatment and its predictors among HIV infected patients in southwest Ethiopia. Int J Gen Med 2017; 10:161-169. [PMID: 28652801 PMCID: PMC5473492 DOI: 10.2147/ijgm.s135305] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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.
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Affiliation(s)
- Adane Teshome Kefale
- Department of Pharmacy, College of Health Sciences, Mizan-Tepi University, Mizan Aman, Ethiopia
| | - Yeniewa Kerie Anagaw
- Department of Pharmacy, College of Health Sciences, Mizan-Tepi University, Mizan Aman, Ethiopia
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Said K, Verver S, Kalingonji A, Lwilla F, Mkopi A, Charalambous S, Reither K. Tuberculosis among HIV-infected population: incidence and risk factors in rural Tanzania. Afr Health Sci 2017; 17:208-215. [PMID: 29026395 DOI: 10.4314/ahs.v17i1.26] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND The incidence of tuberculosis among HIV-infected populations with high CD4 count in high burden countries has not been well studied. OBJECTIVE To assess the TB incidence in HIV-infected adults and its associated risk factors. METHOD A cohort study with retrospective review of medical records and prospective follow-up of HIV-infected adult participants attending CTC who were 18-55 years old, had CD4 count more than 250 cells/mm3 in the period of 2008-2010 and were not on ART at enrolment. Cox proportional hazard regression was used to explore the predictors of incident TB. RESULTS Overall 777 (24%) of 3,279 CTC enrolled HIV-infected adults fulfilled the inclusion criteria of the study. The incidence of TB in the study population ranged from 0.8/100 per person years (PY) at risk (95% CI 0.5-1.3) in the main analysis to 1.7/100 PY at risk (95% CI 1.0-2.6) in sensitivity analyses. Only prior history of TB disease was found to have a significant association with an increased risk of TB, hazard ratio 5.7 (95% CI 2.0-16.4, p value 0.001). CONCLUSION Tuberculosis incidence among HIV-infected adults with medium/high CD4 count in Bagamoyo is lower than in other high TB burden countries. Previously TB treated patients have a much higher risk of getting TB again than those who never had TB before.
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Affiliation(s)
- K Said
- Ifakara Health Institute, Bagamoyo Research and Training Centre, P O Box 74, Tanzania
- Swiss Tropical and Public Health Institute, Socinstrasse 57, 4002, Basel, Switzerland
- University of Basel, Petersplatz 1, 4003 Basel, Switzerland
| | - S Verver
- KNCV Tuberculosis Foundation, and Amsterdam Institute of Global Health and Development, Academic Medical Centre Amsterdam, The Netherlands
- Department of Public Health, Erasmus MC, Rotterdam, The Netherlands
| | - A Kalingonji
- District AIDS Coordinator, CTC, Bagamoyo District Hospital, Bagamoyo, Tanzania
| | - F Lwilla
- Ifakara Health Institute, Bagamoyo Research and Training Centre, P O Box 74, Tanzania
| | - A Mkopi
- Ifakara Health Institute, Bagamoyo Research and Training Centre, P O Box 74, Tanzania
| | - S Charalambous
- Aurum Institute, 29 Queens Road, Johannesburg, 2194, South Africa
| | - K Reither
- Ifakara Health Institute, Bagamoyo Research and Training Centre, P O Box 74, Tanzania
- Swiss Tropical and Public Health Institute, Socinstrasse 57, 4002, Basel, Switzerland
- University of Basel, Petersplatz 1, 4003 Basel, Switzerland
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17
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Prado TND, Rajan JV, Miranda AE, Dias EDS, Cosme LB, Possuelo LG, Sanchez MN, Golub JE, Riley LW, Maciel EL. Clinical and epidemiological characteristics associated with unfavorable tuberculosis treatment outcomes in TB-HIV co-infected patients in Brazil: a hierarchical polytomous analysis. Braz J Infect Dis 2016; 21:162-170. [PMID: 27936379 PMCID: PMC9427597 DOI: 10.1016/j.bjid.2016.11.006] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Revised: 11/12/2016] [Accepted: 11/16/2016] [Indexed: 01/30/2023] Open
Abstract
Background TB patients co-infected with HIV have worse treatment outcomes than non-coinfected patients. How clinical characteristics of TB and socioeconomic characteristics influence these outcomes is poorly understood. Here, we use polytomous regression analysis to identify clinical and epidemiological characteristics associated with unfavorable treatment outcomes among TB-HIV co-infected patients in Brazil. Methods TB-HIV cases reported in the Brazilian information system (SINAN) between January 1, 2001 and December 31, 2011 were identified and categorized by TB treatment outcome (cure, default, death, and development of MDR TB). We modeled treatment outcome as a function of clinical characteristics of TB and patient socioeconomic characteristics by polytomous regression analysis. For each treatment outcome, we used cure as the reference outcome. Results Between 2001 and 2011, 990,017 cases of TB were reported in SINAN, of which 93,147 (9.4%) were HIV co-infected. Patients aged 15–19 (OR = 2.86; 95% CI: 2.09–3.91) and 20–39 years old (OR = 2.30; 95% CI: 1.81–2.92) were more likely to default on TB treatment than those aged 0–14 years old. In contrast, patients aged ≥60 years were more likely to die from TB (OR = 2.22; 95% CI: 1.43–3.44) or other causes (OR = 2.86; 95% CI: 2.14–3.83). Black patients were more likely to default on TB treatment (OR = 1.33; 95% CI: 1.22–1.44) and die from TB (OR = 1.50; 95% CI: 1.29–1.74). Finally, alcoholism was associated with all unfavorable outcomes: default (OR = 1.94; 95% CI: 1.73–2.17), death due to TB (OR = 1.46; 95% CI: 1.25–1.71), death due to other causes (OR = 1.38; 95% CI: 1.21–1.57) and MDR-TB (OR = 2.29; 95% CI: 1.46–3.58). Conclusions Socio-economic vulnerability has a significant effect on treatment outcomes among TB-HIV co-infected patients in Brazil. Enhancing social support, incorporation of alcohol abuse screening and counseling into current TB surveillance programs and targeting interventions to specific age groups are interventions that could improve treatment outcomes.
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Affiliation(s)
- Thiago Nascimento do Prado
- Universidade Federal do Espírito Santo (UFES), Laboratório de Epidemiologia (Lab-Epi), Vitória, ES, Brazil; Universidade Federal do Espírito Santo (UFES), Departamento de Enfermagem, Vitória, ES, Brazil; Universidade Federal do Espírito Santo (UFES), Programa de Pós-Graduação em Doenças Infecciosas, Vitória, ES, Brazil
| | - Jayant V Rajan
- University of California, Department of Medicine, San Francisco, United States
| | - Angélica Espinosa Miranda
- Universidade Federal do Espírito Santo (UFES), Programa de Pós-Graduação em Doenças Infecciosas, Vitória, ES, Brazil
| | - Elias Dos Santos Dias
- Universidade Federal do Espírito Santo (UFES), Departamento de Enfermagem, Vitória, ES, Brazil
| | - Lorrayne Beliqui Cosme
- Universidade Federal do Espírito Santo (UFES), Laboratório de Epidemiologia (Lab-Epi), Vitória, ES, Brazil; Universidade Federal do Espírito Santo (UFES), Departamento de Enfermagem, Vitória, ES, Brazil
| | - Lia Gonçalves Possuelo
- Universidade de Santa Cruz do Sul, Programa de Pós-Graduação em Promoção da Saúde, Santa Cruz do Sul, RS, Brazil
| | - Mauro N Sanchez
- Universidade de Brasília, Departamento de Saúde Pública, Brasília, DF, Brazil; International Union Against Tuberculosis and Lung Disease, Paris, France
| | - Jonathan E Golub
- University of Baltimore, Johns Hopkins School of Medicine, Center for Tuberculosis Research, Baltimore, United States
| | - Lee W Riley
- University of California, School of Public Health, Division of Infectious Disease and Vaccinology, Berkeley, United States
| | - Ethel Leonor Maciel
- Universidade Federal do Espírito Santo (UFES), Laboratório de Epidemiologia (Lab-Epi), Vitória, ES, Brazil; Universidade Federal do Espírito Santo (UFES), Departamento de Enfermagem, Vitória, ES, Brazil; Universidade Federal do Espírito Santo (UFES), Programa de Pós-Graduação em Doenças Infecciosas, Vitória, ES, Brazil.
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Tarekegne D, Jemal M, Atanaw T, Ebabu A, Endris M, Moges F, Tessema B, Deressa T. Prevalence of human immunodeficiency virus infection in a cohort of tuberculosis patients at Metema Hospital, Northwest Ethiopia: a 3 years retrospective study. BMC Res Notes 2016; 9:192. [PMID: 27026410 PMCID: PMC4810509 DOI: 10.1186/s13104-016-2004-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Accepted: 03/23/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Ethiopia is one of the countries that are highly affected by dual epidemics of human immunodeficiency virus (HIV) and tuberculosis (TB). HIV infection is a known risk factor for the development of active TB and it challenges in diagnosis and treatment of TB. Thus, it is essential to determine the epidemiology of HIV infection among TB patients to guide clinical actions and inform the policy makers. This study was aimed to assess the prevalence of HIV infection among TB patients and to describe the associated risk factors for HIV seropositivity. METHODS A retrospective study was conducted on TB registries at Metema Hospital directly observed therapy short-course (DOTS) clinic. Binary and multivariate logistic regression analysis was used to determine the association of HIV seropositivity among TB patients. Odds ratio (OR) and 95% confidence intervals (CI) were calculated. P value less than 0.05 was considered as statistically significant. RESULTS Of the total 2096 patients, 2005 (95.7%) were tested for HIV. The overall HIV-TB co-infection rate was 20.1% (404), 12.3% (246) in males and 7.9% (158) in females. The highest proportion of co-infection rate was observed among the patients in the age group of 25-34 years (32.4%) and smear negative pulmonary TB patients (59.7%). A declining trend of HIV-TB co-infection was observed during the study period, from 22.1% (185) in 2009/10 to 12.8% (52) in 2011/12 (X(2) = 17.07, P < 0.001). CONCLUSIONS This study found that HIV-TB co-infection is still high in the Metema area; and occurs more frequently in males than females, and among patients in age group of 25-34 years. Thus, concerted efforts and interventions methods that target these at risk groups are recommended.
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Affiliation(s)
- Daniel Tarekegne
- School of Biomedical and Laboratory Sciences, University of Gondar, Gondar, Ethiopia
| | - Muhabaw Jemal
- School of Biomedical and Laboratory Sciences, University of Gondar, Gondar, Ethiopia
| | - Tadesse Atanaw
- School of Biomedical and Laboratory Sciences, University of Gondar, Gondar, Ethiopia
| | - Ashenafi Ebabu
- School of Biomedical and Laboratory Sciences, University of Gondar, Gondar, Ethiopia
| | - Mengistu Endris
- School of Biomedical and Laboratory Sciences, University of Gondar, Gondar, Ethiopia
| | - Feleke Moges
- School of Biomedical and Laboratory Sciences, University of Gondar, Gondar, Ethiopia
| | - Belay Tessema
- School of Biomedical and Laboratory Sciences, University of Gondar, Gondar, Ethiopia
| | - Tekalign Deressa
- School of Biomedical and Laboratory Sciences, University of Gondar, Gondar, Ethiopia.
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Nogueira CL, Prim RI, Senna SG, Rovaris DB, Maurici R, Rossetti ML, Couvin D, Rastogi N, Bazzo ML. First insight into the molecular epidemiology of Mycobacterium tuberculosis in Santa Catarina, southern Brazil. Tuberculosis (Edinb) 2016; 97:57-64. [PMID: 26980497 DOI: 10.1016/j.tube.2015.12.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Revised: 12/14/2015] [Accepted: 12/20/2015] [Indexed: 12/01/2022]
Abstract
Molecular epidemiology of Mycobacterium tuberculosis is useful for understanding disease transmission dynamics, and to establish strategic measures for TB control and prevention. The aim of this study was to analyze clinical, epidemiological and molecular characteristics of MTBC clinical isolates from Santa Catarina state, southern Brazil. During one-year period, 406 clinical isolates of MTBC were collected from Central Laboratory of Public Health and typed by spoligotyping. Demographic and clinical data were collected from the Brazilian National Mandatory Disease Reporting System. The majority of cases occurred in highest population densities regions and about 50% had some condition associated with TB. Among all isolates, 5.7% were MDR, which showed association with drug addiction. LAM was the most predominant lineage with 47.5%, followed by the T superfamily with 25.9% and Haarlem with 12.3%. The MST showed two major groups: the first was formed mainly by the LAM lineage and the second was mainly formed by the T and Haarlem lineages. Others lineages were distributed in peripheral positions. This study provides the first insight into the population structure of M. tuberculosis in SC State. Spoligotyping and other genotyping analyses are important to establish strategic measures for TB control and prevention.
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Affiliation(s)
- Christiane Lourenço Nogueira
- Universidade Federal de Santa Catarina - UFSC, Campus Universitário, s/n. Florianópolis, Santa Catarina, Brazil.
| | - Rodrigo Ivan Prim
- Universidade Federal de Santa Catarina - UFSC, Campus Universitário, s/n. Florianópolis, Santa Catarina, Brazil.
| | - Simone Gonçalves Senna
- Universidade Federal de Santa Catarina - UFSC, Campus Universitário, s/n. Florianópolis, Santa Catarina, Brazil.
| | - Darcita Büerger Rovaris
- Laboratório Central Do Estado de Santa Catarina - LACEN/SC, Florianópolis, Santa Catarina, Brazil.
| | - Rosemeri Maurici
- Universidade Federal de Santa Catarina - UFSC, Campus Universitário, s/n. Florianópolis, Santa Catarina, Brazil.
| | - Maria Lúcia Rossetti
- Fundação Estadual de Produção e Pesquisa em Saúde Do Rio Grande Do Sul - FEEPS/RS, Porto Alegre, Rio Grande Do Sul, Brazil.
| | - David Couvin
- WHO Supranational TB Reference Laboratory, Institut Pasteur de la Guadeloupe, Abymes, Guadeloupe, France.
| | - Nalin Rastogi
- WHO Supranational TB Reference Laboratory, Institut Pasteur de la Guadeloupe, Abymes, Guadeloupe, France.
| | - Maria Luiza Bazzo
- Universidade Federal de Santa Catarina - UFSC, Campus Universitário, s/n. Florianópolis, Santa Catarina, Brazil.
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