Unsuccessful TB treatment outcomes with a focus on HIV co-infected cases: a cross-sectional retrospective record review in a high-burdened province of South Africa

被引:19
作者
Engelbrecht, M. C. [1 ]
Kigozi, N. G. [1 ]
Chikobvu, P. [2 ,3 ]
Botha, S. [4 ]
van Rensburg, H. C. J. [1 ]
机构
[1] Univ Free State, Ctr Hlth Syst Res & Dev, POB 339, ZA-9300 Bloemfontein, South Africa
[2] Free State Dept Hlth, POB 277, ZA-9300 Bloemfontein, South Africa
[3] Univ Free State, Dept Community Hlth, POB 339, ZA-9300 Bloemfortein, South Africa
[4] JPS Africa, Postnet Suite 132,Private Bag X14, ZA-0011 Brooklyn, South Africa
关键词
Tuberculosis (TB); TB-HIV co-infection; Unsuccessful treatment outcomes; Electronic TB register; Retrospective record review; South Africa; ANTIRETROVIRAL THERAPY; TUBERCULOSIS PATIENTS; MORTALITY; PROGRAM; ADULTS; START;
D O I
10.1186/s12913-017-2406-x
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Background: South Africa did not meet the MDG targets to reduce TB prevalence and mortality by 50% by 2015, and the TB cure rate remains below the WHO target of 85%. TB incidence in the country is largely fuelled by the HIV epidemic, and co-infected patients are more likely to have unsuccessful TB treatment outcomes. This paper analyses the demographic and clinical characteristics of new TB patients with unsuccessful treatment outcomes, as well as factors associated with unsuccessful treatment outcomes for HIV co-infected patients. Methods: A cross-sectional retrospective record review of routinely collected data for new TB cases registered in the Free State provincial electronic TB database between 2009 and 2012. The outcome variable, unsuccessful treatment, was defined as cases >= 15 years that 'died', 'failed' or 'defaulted' as the recorded treatment outcome. The data were subjected to descriptive and logistic regression analyses. Results: From 2009 to 2012 there were 66,940 new TB cases among persons >= 15 years (with a recorded TB treatment outcome), of these 61% were co-infected with HIV. Unsuccessful TB treatment outcomes were recorded for 24.5% of co-infected cases and 15.3% of HIV-negative cases. In 2009, co-infected cases were 2.35 times more at risk for an unsuccessful TB treatment outcome (OR: 2.35; CI: 2.06-2.69); this figure decreased to 1.8 times by 2012 (OR: 1.80; CI: 1.63-1.99). Among the co-infected cases, main risk factors for unsuccessful treatment outcomes were: >= 65 years (AOR: 1.71; CI: 1.25-2.35); receiving treatment in healthcare facilities in District D (AOR: 1.15; CI 1.05-1.28); and taking CPT (and not ART) (AOR: 1.28; CI: 1.05-1.57). Females (AOR: 0.93; CI: 0.88-0.99) and cases with a CD4 count > 350 (AOR: 0.40; CI: 0.36-0.44) were less likely to have an unsuccessful treatment outcome. Conclusions: The importance of TB-HIV/ AIDS treatment integration is evident as co-infected patients on both ART and CPT, and those who have a higher CD4 count are less likely to have an unsuccessful TB treatment outcome. Furthermore, co-infected patients who require more programmatic attention are older people and males.
引用
收藏
页数:10
相关论文
共 36 条
  • [1] Treatment outcome and its attributes in TB-HIV co-infected patients registered under Revised National TB Control Program: a retrospective cohort analysis
    Ambadekar, N. N.
    Zodpey, S. P.
    Soni, R. N.
    Lanjewar, S. P.
    [J]. PUBLIC HEALTH, 2015, 129 (06) : 783 - 789
  • [2] [Anonymous], 2006, GUID COTR PROPH HIV
  • [3] [Anonymous], 2012, WHO Policy on Collaborative TB/HIV Activities: Guidelines for National Programmes and Other Stakeholders
  • [4] [Anonymous], GLOB TUB REP 2013
  • [5] [Anonymous], 2013, UNAIDS REP GLOB AIDS
  • [6] Treatment outcome of human immunodeficiency virus and tuberculosis co-infected patients in public hospitals of eastern and southern zone of Tigray region, Ethiopia
    Belayneh, Mehretu
    Giday, Kalayta
    Lemma, Hailemariam
    [J]. BRAZILIAN JOURNAL OF INFECTIOUS DISEASES, 2015, 19 (01) : 47 - 51
  • [7] Earlier versus Later Start of Antiretroviral Therapy in HIV-Infected Adults with Tuberculosis
    Blanc, Francois-Xavier
    Sok, Thim
    Laureillard, Didier
    Borand, Laurence
    Rekacewicz, Claire
    Nerrienet, Eric
    Madec, Yoann
    Marcy, Olivier
    Chan, Sarin
    Prak, Narom
    Kim, Chindamony
    Lak, Khemarin Kim
    Hak, Chanroeurn
    Dim, Bunnet
    Sin, Chhun Im
    Sun, Sath
    Guillard, Bertrand
    Sar, Borann
    Vong, Sirenda
    Fernandez, Marcelo
    Fox, Lawrence
    Delfraissy, Jean-Francois
    Goldfeld, Anne E.
    [J]. NEW ENGLAND JOURNAL OF MEDICINE, 2011, 365 (16) : 1471 - 1481
  • [8] Brust JCM, 2010, INT J TUBERC LUNG D, V14, P413
  • [9] Carlsson Marie, 2014, Tuberc Res Treat, V2014, P984218, DOI 10.1155/2014/984218
  • [10] Churchyard GJ, 2014, SAMJ S AFR MED J, V104, P244, DOI [10.7196/SAMJ.7689, 10.7196/samj.7689]