Integrating tuberculosis/HIV treatment: an evaluation of the tuberculosis outcomes of patients co-infected with tuberculosis and HIV in the Breede Valley subdistrict

Background: The Infectious Disease Clinic of Worcester Hospital introduced an integrated tuberculosis/human immunodeficiency virus (HIV) service in July 2009 to provide comprehensive management to patients who were co-infected with tuberculosis and HIV. Method: In a retrospective cohort study that was carried out from 1 July 2009 to 31 March 2010, the tuberculosis outcomes of co-infected patients attending the Infectious Disease Clinic for antiretroviral (ARV) treatment and receiving their tuberculosis medication at the Infectious Disease Clinic, were compared with those of patients receiving ARV treatment at the Infectious Disease Clinic and tuberculosis treatment at their local clinic. Results: Seventy-four per cent of patients completed their treatment and 26% were cured, with no defaults or deaths, in the tubercuolosis/HIV integrated cohort. Thirty-eight per cent completed their treatment, 45% were cured, 9% died and another 9% defaulted in the cohort receiving their tuberculosis treatment at a local clinic. This indicates that there was a significantly better tuberculosis outcome in the tuberculosis/HIV cohort (p-value < 0.05). Conclusion: The significantly better tuberculosis outcome that resulted when tuberculosis and HIV services were integrated led to services being integrated in the Breede Valley subdistrict.