Impact of HIV Status on Treatment Outcome of Tuberculosis Patients Registered at Arsi Negele Health Center, Southern Ethiopia: A Six Year Retrospective Study

Abstract

BackgroundDespite implementation of different strategies, the burden and mortality of human immunodeficiency virus (HIV)-associated tuberculosis (TB) remains a challenge in Ethiopia. The aim of this study was to assess the impact of HIV status on treatment outcome of tuberculosis patients registered at Arsi Negele Health Center, Southern Ethiopia.MethodsA six-year retrospective data (from September 2008 to August 2014) of tuberculosis patients (n = 1649) registered at the directly observed therapy short-course (DOTS) clinic of Arsi Negele Health Center was reviewed. Treatment outcome and tuberculosis type were categorized according to the national tuberculosis control program guideline. Data were entered and analyzed using SPSS version 20. Multinomial logistic regression analysis was used to examine the effect of HIV status separately on default/failure and death in relation to those who were successfully treated. Odds ratios with 95% confidence intervals were used to check the presence and strength of association between TB treatment outcome and HIV status and other independent variables.ResultsOut of the 1649 TB patients, 94.7% (1562) have been tested for HIV of whom 156(10%) were HIV co-infected. The mean (standard deviation) age of the patients was 28.5(15.5) years. The majority were new TB cases (96.7%), male (53.7%), urban (54.7%), and had smear negative pulmonary TB (44.1%). Overall, the treatment success rate of TB patients with or without HIV was 87.3%. Using cure/completion as reference, patients without known HIV status had significantly higher odds of default /failure [aOR, 4.26; 95%CI, 1.684–10.775] and transfer-out [aOR, 2.92; 95%CI, 1.545–5.521] whereas those who tested positive for HIV had a significantly higher odds of death [aOR, 6.72; 95%CI, 3.704–12.202] and transfer-out [aOR, 2.02; 95%CI, 1.111–3.680].ConclusionOverall, treatment outcome and HIV testing coverage for TB patients is promising to reach the WHO target in the study area. However, default/failure among patients without known HIV status, and higher rate of mortality among HIV positive TB patients and transfer-out cases deserves concern. Therefore further prospective studies on quality of services, socioeconomics and psychology of this group should be conducted.

Treatment outcomes of tuberculosis patients under directly observed treatment short-course at Debre Tabor General Hospital, northwest Ethiopia: nine-years retrospective study

“…This might be due to the statistical pooling effect of the reference groups. In contrast to our study, other studies have shown an association between HIV co-infection and TB treatment outcome [27,35].…”

“…In the present study, the proportion of patients with successful treatment outcomes (cured and completed) was found to be 90.9%, which is higher than the WHO target set for the Millennium Development Goal(MDG) of 85% [31][32][33] and comparable to that of the milestone target set globally for 2025 of > 90% [1,34].Comparable findings were reported by other Ethiopian studies [5,26,[35][36][37].…”

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

“…TB treatment outcome is poor among HIV positive TB patients compared with HIV negative TB patients 13–17. There is a continuing need to routinely assess the likely reasons for poor treatment outcome among TB/HIV co-infected patients.…”

Assessment of Success Rate of Directly Observed Treatment Short-Course (DOTS) in Tuberculosis Patients of South India

“…Studies conducted in Uzbekistan and Ethiopia showed the unfavorable treatment outcomes in TB with HIV patients. 24,25 The TSR among re-treatment cases was much lower than new smear positive patients. This was supported by previous studies where re-treatment cases were significantly associated with unsuccessful treatment outcome.…”