Shaweno, Debebe (2010) Clinical Presentation and Treatment Outcome of TB among HIV Positive TB Patients on Short Course Dots in Hawassa Health Center. Masters thesis, Addis Ababa University.
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Abstract
Background information: In contrast to, many initiatives implemented to tackle Tuberculosis, many countries have not so far reached the targets set by WHO. The main reason mentioned so far was the impact of HIV infection. Therefore, it is essential to determine the impact of HIV/AIDs on the clinical presentation and treatment outcome of tuberculosis locally. Objectives: To compare clinical presentation, treatment outcome of TB and on treatment survival among HIV positive and negative TB patients who are through (DOTs). Methods: A retrospective cohort study design was employed to compare the clinical presentation of TB and its respective treatment outcome between the exposed; HIV positive (n=370) and non exposed; HIV negative TB patients (n=370) who were through the short course DOTs in Hawassa Health Center from 2006-2010. Patient’s HIV status during the diagnosis of TB or initiation of DOTs was considered as an exposure and TB treatment outcome was considered as the outcome variables. Standard WHO definition, is used to classify tuberculosis cases and TB treatment outcomes. Results: Smear negative PTB was significantly the frequent presentation, 0.32, 95%CI (0.25, 0.39; Z=8.76, P=0.000) among HIV positive study subjects, while significant difference in proportion of smear positive PTB; (-0.26; 95%CI (-0.33 -0.19; Z=-6.25, P=0.000) was in favor of HIV negative individuals. Compared to HIV negative TB patients ,cure rate was substantially lower in HIV positive TB patients (73% vs. 87.9%, z=-2.5, P=0.04), and the risk of death was statistically higher among TB/HIV co infected patients; AHR=1.6, 95%CI(1.01-2.6) during the course of DOTs. Regarding survival of TB patients, the survival probability was lower for HIV/TB co infected patients (Log rank test= 6.90, df= 2,P= 0.008).When adjusted for covariates, the survival probability is below 15% for HIV positive but above 85% in HIV negative TB patients at the end of DOTs period(8th month). The independent predictors of death, while on treatment are age, weight and HIV infection. Conclusion: On TB treatment survival probability and cure rate are substantially lower in HIV infected TB patients due to an increased death and unfavorable treatment out comes for the former and the later respectively. Therefore targeted and comprehensive management of TB should be considered in this group of patients.
| Item Type: | Thesis (Masters) |
|---|---|
| Uncontrolled Keywords: | Clinical presentation, treatment outcome, survival of TB patients, Hawassa health center |
| Subjects: | R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine R Medicine > RA Public aspects of medicine > RA1001 Forensic Medicine. Medical jurisprudence. Legal medicine |
| Divisions: | Africana |
| Depositing User: | Vincent Mpoza |
| Date Deposited: | 17 Oct 2018 07:57 |
| Last Modified: | 17 Oct 2018 07:57 |
| URI: | http://thesisbank.jhia.ac.ke/id/eprint/6855 |
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