Management of tuberculosis and HIV co-infection in Cotonou, Benin

Agodokpessi, G.; Alcalá-Cerra, Gabriel; Adè, S.; Wachinou, Prudence; Affolabi, Dissou; Anagonou, S.; Gninafon, M.

doi:10.1016/j.medmal.2012.07.012

Cited by 8 publications

(12 citation statements)

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“…The majority of the studies were conducted in the African (n = 11, 52%) [14], [23], [24], [25], [26], [27], [28], [29], [30], [31], [32] and South-East Asian (n = 7, 33%) [33], [34], [35], [36], [37], [38], [39] regions; two studies were conducted in South America [40], [41] and one in Europe [42]. Four out of seven studies in the South-East Asian region were conducted in Thailand [33], [35], [37], [38] while one used data from eighteen sites in the Asia-Pacific region [39].…”

Section: Resultsmentioning

confidence: 99%

“…More than half of included studies (n = 13, 62%) described a retrospective cohort [23], [24], [25], [27], [34], [37], [40], [42], seven (33.3%) described prospective cohort studies [14], [26], [33], [35], [38], [41] and one was a clinical trial [36]. We excluded seven papers [5], [6], [7], [8], [9], [43], [44] reporting results from large trials that focused on time of ART initiation during TB treatment as TB mortality data was only reported at time points that lay beyond our pre-specified ‘during treatment’ period [6], [7], [43], [44], the outcome was death combined with AIDS-defining illness and mortality data could not be extrapolated [7] or focused only on tuberculous meningitis [9].…”

Section: Resultsmentioning

confidence: 99%

“…Study enrollment periods ranged from 4 months [30] to 8 years [40]. The majority of the studies were conducted predominantly in urban settings (n = 14, 66.7%) [12], [23], [24], [25], [26], [29], [30], [31], [32], [36], [40], [41], [42]. Table 2 shows the levels of quality assigned to each study.…”

Section: Resultsmentioning

confidence: 99%

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The Impact of Antiretroviral Therapy on Mortality in HIV Positive People during Tuberculosis Treatment: A Systematic Review and Meta-Analysis

et al. 2014

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ObjectiveTo quantify the impact of antiretroviral therapy (ART) on mortality in HIV-positive people during tuberculosis (TB) treatment.DesignWe conducted a systematic literature review and meta-analysis. Studies published from 1996 through February 15, 2013, were identified by searching electronic resources (Pubmed and Embase) and conference books, manual searches of references, and expert consultation. Pooled estimates for the outcome of interest were acquired using random effects meta-analysis.SubjectsThe study population included individuals receiving ART before or during TB treatment.Main Outcome MeasuresMain outcome measures were: (i) TB-case fatality ratio (CFR), defined as the proportion of individuals dying during TB treatment and, if mortality in HIV-positive people not on ART was also reported, (ii) the relative risk of death during TB treatment by ART status.ResultsTwenty-one studies were included in the systematic review. Random effects pooled meta-analysis estimated the CFR between 8% and 14% (pooled estimate 11%). Among HIV-positive TB cases, those receiving ART had a reduction in mortality during TB treatment of between 44% and 71% (RR = 0.42, 95%CI: 0.29–0.56).ConclusionStarting ART before or during TB therapy reduces the risk of death during TB treatment by around three-fifths in clinical settings. National programmes should continue to expand coverage of ART for HIV positive in order to control the dual epidemic.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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The Impact of Antiretroviral Therapy on Mortality in HIV Positive People during Tuberculosis Treatment: A Systematic Review and Meta-Analysis

et al. 2014

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“…Low and middle income countries, many of which are located in sub-Saharan Africa, are the most affected, with the main contributing factors being extreme poverty and a high prevalence of Human Immunodeficiency Virus (HIV) infection [1] [2]. HIV is the most important risk factor for TB and is also known to negatively impact treatment outcomes of co-infected TBHIV patients [3] [4]. Women are more vulnerable at acquiring HIV infection compared with men [5], and therefore they are at higher risk of developing TB [4].…”

Section: Introductionmentioning

confidence: 99%

Diagnosis and Treatment Outcomes of Tuberculosis in Relation to Gender and HIV STATUS in South Benin

Wachinou¹,

Adè²,

Agodokpessi³

et al. 2017

JTR

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Background: In Benin, little is known about the influence of both gender and HIV-status on diagnostic patterns and treatment outcomes of Tuberculosis (TB) patients. Objective: To assess whether differences in gender and HIV status affect diagnostic patterns and treatment outcomes of TB patients. Methods: Retrospective cohort study of patients registered in 2013 and 2014 in the three largest TB Basic Management Units in south Benin. Results: Of 2694 registered TB patients, 1700 (63.1%) were male. Case notification rates were higher in males compared with females (96 vs 53/100,000 inhabitants). The male to female ratio was 1:1 in HIV positive patients, but was 2:1 among HIV negative cases. In HIV-positive patients, there were no differences in TB types between men and women. In HIV-negative patients, there were significantly higher proportions of females with clinically diagnosed pulmonary TB (p = 0.04) and extrapulmonary TB (p < 0.001). Retreatment TB was 4.65 times higher amongst males compared with females. For New bacteriologically confirmed pulmonary TB, no differences were observed in treatment outcomes between genders in the HIV positive group; but significantly more unfavorable outcomes were reported among HIV negative males, with higher rates of failure (p < 0.001) and loss-to-follow up (p = 0.02). Conclusion: The study has shown that overall TB notification rates were higher in males than in females in south Benin, with more females co-infected with HIV. Unfavorable outcomes were more common in HIV-negative males.

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“…4 Conversely, a reduction in the incidence of S. peumoniae invasive disease (bacteremia) has been observed. 5 Pulmonary tuberculosis (TBC) has always been a worldwide health problem with a great impact in the pre-HAART era, in HIV/AIDS population [6][7][8][9] even in the developed world. Nowadays, pulmonary tuberculosis develops in HIV patients with relatively good immunological control and its incidence has become close to that of the immunocompetent population of the same geographical area.…”

Section: Introductionmentioning

confidence: 99%

Changes in the etiology, incidence and prognosis of acute lower respiratory track infections in human immunodeficiency virus patients

Perelló

Escoda

Camón

et al. 2015

Enfermedades Infecciosas y Microbiología Clínica

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a b s t r a c tAim: To describe the, incidence, the changes in the etiology and the prognosis of lower respiratory tract infection (LRTI) in HIV infected patients, presenting by the first time to the Emergency Department (ED), during years 2000-2010. Study design: Prospective collection of data. Metbods: Data were collected on the first visit of HIV-infected patients at our ED due to a LRTI, (defined according to the criteria of the European Respiratory Society), between 1/1/2000 and 31/12/2010. A series of epidemiological and laboratory variables as well as the need for admission to the intensive care unit (ICU). LRTI etiology were also collected. The influence ofthe mentioned variables on 30-day mortality were analyzed. Results: One hundred thirty one patients were included. LRTI represented 27% of visits to the ED by HIV-infected patients. Mean age was 39±9 years. 72% of patients were males. 18% required admission to the ICU. The most frequent LRTI was pneumonia by P. jiroveci in 35 cases, bacterial penumonia in 27 and pulmonary tuberculosis in 20. LRTI incidence gradually reduced significantly over time from 6.13 × 1000 patients/year in year 2000 to 0.23 × 1000 patients/year in 2010 (p<0.05). Overall mortality was 14%. Logistic regression analysis showed that admission to ICU (p<0.004) and viral load (p<0.029) were independent variables predicting mortality. Conclusion: LRTI is a pathology with a decreasing incidence, probably related to the widespread utilization increased of HAART regimens. lts etiology has also been changing, but with a non negligible mortality, mostly when ICU admission was required.© 2014 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.Cambios en la etiología, incidencia y pronóstico de la infección respiratoria aguda de vías bajas en pacientes infectados por el virus de la inmunodeficiencia humana Infecc Microbiol Clin. 2014;xxx(xx):xxx-xxx así como la necesidad de ingreso en una unidad de cuidados intensivos (UCI). Se estudió la etiología de la IRVB y la incidencia. Finalmente se analizaron la influencia de las variables con la mortalidad a 30 días. Resultados: Se incluyeron un total de 131 pacientes. La edad media fue de 39 ± 9 años. El 72% de los pacientes eran varones y el 18% de los pacientes requirieron ingreso en la UCI. La IRVB más frecuente fue la neumonía por P. jirovecci, seguida de la neumonía bacteriana en 27 y la tuberculosis pulmonar en 20. La incidencia de IRVB se ha ido reduciendo gradualmente de forma significativa, 6,13 × 1.000 pacientes/año en 2000 a 0,23 × 1.000 pacientes/año en 2010 (p < 0,05). El análisis de regresión logística mostró que la única variable que predijo mortalidad fue el ingreso en UCI (p < 0,05; OR: 73,01). Conclusión: La IRVB es una enfermedad cuya incidencia y etiología han ido disminuyendo y cambiando respectivamente, probablemente en relación con la utilización generalizada del TAR. Sin embargo, todavía presenta una mortalidad nada despreciable, que es mayor cuando el paci...

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Management of tuberculosis and HIV co-infection in Cotonou, Benin

Cited by 8 publications

References 14 publications

The Impact of Antiretroviral Therapy on Mortality in HIV Positive People during Tuberculosis Treatment: A Systematic Review and Meta-Analysis

The Impact of Antiretroviral Therapy on Mortality in HIV Positive People during Tuberculosis Treatment: A Systematic Review and Meta-Analysis

Diagnosis and Treatment Outcomes of Tuberculosis in Relation to Gender and HIV STATUS in South Benin

Changes in the etiology, incidence and prognosis of acute lower respiratory track infections in human immunodeficiency virus patients

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