N N Ambadekar1, S P Zodpey2, R N Soni3, S P Lanjewar4. 1. Dept of Public Health, Akola, Maharashtra, India. 2. Public Health Foundation of India, New Delhi, India. 3. Office of the World Health Organization (WHO) Representative in India, WHO Country Office, New Delhi, India. Electronic address: rachana_soni@yahoo.in. 4. Civil Hospital & SVN Govt Medical College, Civil Lines, Yavatmal, India.
Abstract
OBJECTIVES: DOTS treatment has shown to be effective in TB patients with or without HIV infection although there have been some conflicting evidence. This may be due to various factors associated with HIV-TB co-infection and its treatment. Thus the present study was planned to study the outcome of DOTS and factors associated with same in TB-HIV co-infected patients. STUDY DESIGN: A retrospective cohort analysis was done. METHODS: 886 TB-HIV co-infected patients who were registered under RNTCP were the subjects. Data from RNTCP was obtained on diagnosis of TB, HIV and TB therapy and some attributes. RESULTS: Average cure rate for NSP TB-HIV co-infected patients was 72% compared with 83% of total NSP registered patients (P < 0.001). Death rate in NSP TB-HIV co-infected patients was 16% (P < 0.001). In non-NSP TB-HIV co-infected patients, success rate was 80%. Death rate was significantly higher i.e. 12% in non-NSP TB-HIV co-infected cases as compared with 6% in total registered patients. Death rate was 19% in RT TB-HIV co-infected patients while 11% in all registered RT cases (P < 0.001). In TB-HIV co-infected patients paediatric patients, patients with extra pulmonary TB and new patients without any history of previous treatment had a higher chance of success at treatment. Patients with Pulmonary TB had higher chance of death. CONCLUSION: Success rate was significantly lower and death rate was significantly higher among the TB-HIV co-infected cohort with age, type of TB and history of previous treatment affecting the success rate of treatment and type of TB affecting the death rate.
OBJECTIVES: DOTS treatment has shown to be effective in TB patients with or without HIV infection although there have been some conflicting evidence. This may be due to various factors associated with HIV-TB co-infection and its treatment. Thus the present study was planned to study the outcome of DOTS and factors associated with same in TB-HIV co-infected patients. STUDY DESIGN: A retrospective cohort analysis was done. METHODS: 886 TB-HIV co-infected patients who were registered under RNTCP were the subjects. Data from RNTCP was obtained on diagnosis of TB, HIV and TB therapy and some attributes. RESULTS: Average cure rate for NSP TB-HIV co-infected patients was 72% compared with 83% of total NSP registered patients (P < 0.001). Death rate in NSP TB-HIV co-infected patients was 16% (P < 0.001). In non-NSP TB-HIV co-infected patients, success rate was 80%. Death rate was significantly higher i.e. 12% in non-NSP TB-HIV co-infected cases as compared with 6% in total registered patients. Death rate was 19% in RT TB-HIV co-infected patients while 11% in all registered RT cases (P < 0.001). In TB-HIV co-infected patients paediatric patients, patients with extra pulmonary TB and new patients without any history of previous treatment had a higher chance of success at treatment. Patients with Pulmonary TB had higher chance of death. CONCLUSION: Success rate was significantly lower and death rate was significantly higher among the TB-HIV co-infected cohort with age, type of TB and history of previous treatment affecting the success rate of treatment and type of TB affecting the death rate.
Authors: Lily Ogyiri; Margaret Lartey; Oluwayemisi Ojewale; Andrew Anthony Adjei; Awewura Kwara; Richard Mawuena Adanu; Kwasi Torpey Journal: Pan Afr Med J Date: 2019-04-26