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Published in: BMC Public Health 1/2019

Open Access 01-12-2019 | Tuberculosis | Research article

Treatment Outcome of Tuberculosis and Associated Factors among TB-HIV Co-Infected Patients at Public Hospitals of Harar Town, Eastern Ethiopia. A five-year retrospective study

Authors: Assefa Tola, Kirubel Minsamo Mishore, Yohanes Ayele, Abraham Nigussie Mekuria, Nanati Legese

Published in: BMC Public Health | Issue 1/2019

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Abstract

Background

The bidirectional relationship between the twin epidemics of Tuberculosis (TB) and Human Immunodeficiency Virus (HIV) causes major global health challenges in the twenty-first century. TB-HIV co-infected people are facing multifaceted problems like high lost to follow up rates, poor treatment adherence, high TB recurrence rate, and high mortality risk. Our objective was to assess the outcomes of TB treatment and associated factors among TB-HIV co-infected patients in Harar town, Eastern part of Ethiopia, 2018.

Methods

A retrospective study was conducted among systematically selected 349 TB/HIV co-infected patients who registered from 2012 to 2017 in two public hospitals in Harar town. The data were collected through document review by using a pre-tested structured data extraction checklist. The data were analyzed using SPSS Version 21. Bivariate and multivariate logistic regression were determined at 95% confidence intervals.

Results

Among the 349 TB/HIV co-infected patients included in the study, 30.1% were cured, 56.7% had completed their treatment, 7.7% died, 1.7% were lost to follow up, and 3.7% were treatment failure. Overall, 86.8% of the TB-HIV co-infected patients had successful TB treatment outcomes. The patients who were on re-treatment category (AOR = 2.91, 95% CI: 1.17–7.28), who had a history of opportunistic infection (AOR = 3.68, 95% CI: 1.62–8.33), and who did not take co-trimoxazole prophylaxis (AOR = 3.54, 95% CI: 1.59–7.89) had 2.91, 3.68, and 3.54 times higher odds of having unsuccessful TB treatment outcome than their counterparties, respectively. The chance of unsuccessful TB treatment outcome was 4.46 (95% CI: 1.24–16.02), 5.94 (95% CI: 1.87–18.85), and 3.01 (95% CI: 1.15–7.91) times higher among TB/HIV patients in stage 2, 3 and 4 than those in stage 1, respectively.

Conclusions

The overall rate of the success of the TB treatment among TB-HIV co-infected patients in this study was higher compared with many previous studies. TB/HIV patients with a history of previous TB treatment, smear-positive pulmonary TB, late HIV stage, history of opportunistic infection and not being on co-trimoxazole prophylaxis therapy were at a high risk of getting poor treatment outcomes.
Literature
1.
go back to reference Bruchfeld J, Correia-Neves M. Llenius GK. Tuberculosis and HIV Coinfection. Cold Spring Harb Perspect Med. 2015;5:1–16.CrossRef Bruchfeld J, Correia-Neves M. Llenius GK. Tuberculosis and HIV Coinfection. Cold Spring Harb Perspect Med. 2015;5:1–16.CrossRef
2.
go back to reference Tesfaye B, Alebel A, Gebrie A, Zegeye A, Tesema C, Kassie B. The twin epidemics: Prevalence of TB/HIV coinfection and its associated factors in Ethiopia. Syst Rev Metaanal PLoS ONE. 2018;13(10).CrossRef Tesfaye B, Alebel A, Gebrie A, Zegeye A, Tesema C, Kassie B. The twin epidemics: Prevalence of TB/HIV coinfection and its associated factors in Ethiopia. Syst Rev Metaanal PLoS ONE. 2018;13(10).CrossRef
3.
go back to reference Mburu G, Richardson DA. Community-based TB and HIV integration. Good Practice Guide. In: Hove. IHAAaP, editor. The first edition ed2013. Mburu G, Richardson DA. Community-based TB and HIV integration. Good Practice Guide. In: Hove. IHAAaP, editor. The first edition ed2013.
4.
go back to reference The Federal Democratic Republic of Ethiopia MoH. National comprehensive tuberculosis, leprosy and TB/HIV training manual for health care workers. Addis Ababa November 2016. The Federal Democratic Republic of Ethiopia MoH. National comprehensive tuberculosis, leprosy and TB/HIV training manual for health care workers. Addis Ababa November 2016.
5.
go back to reference WHO. Global tuberculosis report 2018 Geneva: World Health Organization; 2018. WHO. Global tuberculosis report 2018 Geneva: World Health Organization; 2018.
6.
go back to reference Health FMO. National guidelines for comprehensive HIV prevention, care, and treatment. Addis Ababa: Federal Ministry Of Health; 2017. Health FMO. National guidelines for comprehensive HIV prevention, care, and treatment. Addis Ababa: Federal Ministry Of Health; 2017.
7.
go back to reference WHO. TB/HIV: HIV-Associated Tuberculosis World Health Organization; 2018. WHO. TB/HIV: HIV-Associated Tuberculosis World Health Organization; 2018.
8.
go back to reference WHO. Latent tuberculosis infection: updated and consolidated guidelines for programmatic management. Geneva: World Health Organization; 2018. WHO. Latent tuberculosis infection: updated and consolidated guidelines for programmatic management. Geneva: World Health Organization; 2018.
9.
go back to reference WHO. WHO policy on collaborative TB/HIV activities: Guidelines for national programs and other stakeholders. World Health Organization 2012. WHO. WHO policy on collaborative TB/HIV activities: Guidelines for national programs and other stakeholders. World Health Organization 2012.
10.
go back to reference Kebede A. Technical guideline for tuberculosis (TB) and TB-HIV program implementation. World Vis. 2017. Kebede A. Technical guideline for tuberculosis (TB) and TB-HIV program implementation. World Vis. 2017.
11.
go back to reference Belay M, Bjune G, Abebe F. Prevalence of tuberculosis, HIV, and TB-HIV co-infection among pulmonary tuberculosis suspects in a predominantly pastoralist area, northeast Ethiopia. Glob Health Action. 2015;8(1).CrossRef Belay M, Bjune G, Abebe F. Prevalence of tuberculosis, HIV, and TB-HIV co-infection among pulmonary tuberculosis suspects in a predominantly pastoralist area, northeast Ethiopia. Glob Health Action. 2015;8(1).CrossRef
12.
go back to reference MOH E-. National TB/HIV Sentinel Surveillance. One year Report (July 2011–June 2012). Ethiopian Health and nutrition research institute (EHNRI)/ Ministry of Health (MOH) with technical and financial support of PAPFAR trough the center for disease control-Ethiopia 2013. MOH E-. National TB/HIV Sentinel Surveillance. One year Report (July 2011–June 2012). Ethiopian Health and nutrition research institute (EHNRI)/ Ministry of Health (MOH) with technical and financial support of PAPFAR trough the center for disease control-Ethiopia 2013.
13.
go back to reference Frontières MS, Partnership ST. OUT OF STEP 2017. TB policies in 29 countries. A survey of prevention, testing and treatment policies and practices July 2017. Frontières MS, Partnership ST. OUT OF STEP 2017. TB policies in 29 countries. A survey of prevention, testing and treatment policies and practices July 2017.
14.
go back to reference WHO. THE END TB STRATEGY: Global strategy and targets for tuberculosis prevention, care, and control after 2015. Geneva World Health Organization 2014. WHO. THE END TB STRATEGY: Global strategy and targets for tuberculosis prevention, care, and control after 2015. Geneva World Health Organization 2014.
15.
go back to reference Health FMo. National Consolidated Guidelines for comprehensive HIV prevention, care and treatment. Addis Ababa, Ethiopia August 2018. Health FMo. National Consolidated Guidelines for comprehensive HIV prevention, care and treatment. Addis Ababa, Ethiopia August 2018.
16.
go back to reference Belayneh M, Giday K, Lemma H. Treatment outcome of human immunodeficiency virus and tuberculosis co-infected patients in public hospitals of the eastern and southern zone of Tigray region, Ethiopia. Bras J Infect Dis Poverty. 2015;19(1):47–51.CrossRef Belayneh M, Giday K, Lemma H. Treatment outcome of human immunodeficiency virus and tuberculosis co-infected patients in public hospitals of the eastern and southern zone of Tigray region, Ethiopia. Bras J Infect Dis Poverty. 2015;19(1):47–51.CrossRef
17.
go back to reference Fiseha T, Gebru T. H G, Y D. tuberculosis treatment outcome among HIV co-infected patients at Mizan- Aman general hospital, Southwest Ethiopia: a retrospective study. J Bioeng Biomed Sci. 2015;5(139):1–4. Fiseha T, Gebru T. H G, Y D. tuberculosis treatment outcome among HIV co-infected patients at Mizan- Aman general hospital, Southwest Ethiopia: a retrospective study. J Bioeng Biomed Sci. 2015;5(139):1–4.
18.
go back to reference Kefale AT, Anagaw YK. The outcome of tuberculosis treatment and its predictors among HIV infected patients in Southwest Ethiopia. Int J Gen Med. 2017;10:161–70.CrossRef Kefale AT, Anagaw YK. The outcome of tuberculosis treatment and its predictors among HIV infected patients in Southwest Ethiopia. Int J Gen Med. 2017;10:161–70.CrossRef
19.
go back to reference Sinshaw Y, Alemu S, Fekadu A, Gizachew M. Successful TB treatment outcome and its associated factors among TB/HIV co-infected patients attending Gondar University Referral Hospital, Northwest Ethiopia: an institution-based cross-sectional study. BMC Infect Dis. 2017;17:1–9.CrossRef Sinshaw Y, Alemu S, Fekadu A, Gizachew M. Successful TB treatment outcome and its associated factors among TB/HIV co-infected patients attending Gondar University Referral Hospital, Northwest Ethiopia: an institution-based cross-sectional study. BMC Infect Dis. 2017;17:1–9.CrossRef
20.
go back to reference The Federal democratic republic of Ethiopia MoH. Guidelines for clinical and programmatic management of TB, Leprosy and TB/HIV in Ethiopia, fifth edition Addis Ababa; April 2012. The Federal democratic republic of Ethiopia MoH. Guidelines for clinical and programmatic management of TB, Leprosy and TB/HIV in Ethiopia, fifth edition Addis Ababa; April 2012.
21.
go back to reference WHO. Definitions and reporting framework for tuberculosis – 2013 revision. Geneva 27, Switzerland: World Health Organization December 2014. WHO. Definitions and reporting framework for tuberculosis – 2013 revision. Geneva 27, Switzerland: World Health Organization December 2014.
22.
go back to reference WHO . Patient monitoring Guidelines for HIV care and Antiretroviral Therapy (ART). Geneva 27, Switzerland: World Health Organization 2006. WHO . Patient monitoring Guidelines for HIV care and Antiretroviral Therapy (ART). Geneva 27, Switzerland: World Health Organization 2006.
23.
go back to reference WHO. Global tuberculosis report 2017. Switzerland, Geneva: World Health Organization; 2017. WHO. Global tuberculosis report 2017. Switzerland, Geneva: World Health Organization; 2017.
24.
go back to reference Jacobson KB, Moll AP, Friedland GH, Shenoi SV. Successful tuberculosis treatment outcomes among HIV/TB Coinfected patients Down- referred from a district hospital to primary Health clinics in rural South Africa. PLoS One. 2015;10(5):1–11. Jacobson KB, Moll AP, Friedland GH, Shenoi SV. Successful tuberculosis treatment outcomes among HIV/TB Coinfected patients Down- referred from a district hospital to primary Health clinics in rural South Africa. PLoS One. 2015;10(5):1–11.
25.
go back to reference Tripathi SB, Kapadia VK. Treatment outcome of tuberculosis in HIV seropositive patients: an experience of the southeast region of Ahmedabad. Natl J Commu Med. 2015;6(4):462–5. Tripathi SB, Kapadia VK. Treatment outcome of tuberculosis in HIV seropositive patients: an experience of the southeast region of Ahmedabad. Natl J Commu Med. 2015;6(4):462–5.
26.
go back to reference Ali SA, Thandisizwe R, Mavundla FR. Awoke T Outcomes of TB treatment in HIV co-infected TB patients in Ethiopia: a cross-sectional analytic study. BMC Infect Dis. 2016;16:9. Ali SA, Thandisizwe R, Mavundla FR. Awoke T Outcomes of TB treatment in HIV co-infected TB patients in Ethiopia: a cross-sectional analytic study. BMC Infect Dis. 2016;16:9.
27.
go back to reference Saini S, Singh M, Garg A. A retrospective cohort study of treatment outcome among HIV positive and HIV negative TB patients in Chandigarh, India. IND J COMMUN HEALTH JUN. 2016;28(02):145–50. Saini S, Singh M, Garg A. A retrospective cohort study of treatment outcome among HIV positive and HIV negative TB patients in Chandigarh, India. IND J COMMUN HEALTH JUN. 2016;28(02):145–50.
28.
go back to reference Cheru F, Mekonen D, Girma T, Belyhun Y, Unakal C, Endris M, et al. Comparison of treatment outcomes of tuberculosis patients with and without HIV in Gondar University Hospital: a retrospective study. J Pharm Biomed Sci. 2013;34:1606–13. Cheru F, Mekonen D, Girma T, Belyhun Y, Unakal C, Endris M, et al. Comparison of treatment outcomes of tuberculosis patients with and without HIV in Gondar University Hospital: a retrospective study. J Pharm Biomed Sci. 2013;34:1606–13.
29.
go back to reference Ismail I, Bulgiba A. Determinants of unsuccessful tuberculosis treatment outcomes in Malaysian HIV-infected patients. Prev Med. 2013;57:S27–30.CrossRef Ismail I, Bulgiba A. Determinants of unsuccessful tuberculosis treatment outcomes in Malaysian HIV-infected patients. Prev Med. 2013;57:S27–30.CrossRef
30.
go back to reference Prado TNd, Rajan JV, Miranda AE, Dias EdS, Cosme LB, Possuelo L Ga, et al. Clinical and epidemiological characteristics associated with unfavorable tuberculosis treatment outcomes in TB-HIV co-infected patients in Brazil: a hierarchical polytomous analysis. Braz J Infect Dis 2017;21(2):162–170. Prado TNd, Rajan JV, Miranda AE, Dias EdS, Cosme LB, Possuelo L Ga, et al. Clinical and epidemiological characteristics associated with unfavorable tuberculosis treatment outcomes in TB-HIV co-infected patients in Brazil: a hierarchical polytomous analysis. Braz J Infect Dis 2017;21(2):162–170.
31.
go back to reference Ejeta E, Birhanu T, Wolde T. Tuberculosis treatment outcomes among tuberculosis/human immunodeficiency co-infected cases treated under directly observed treatment of short course in Western Ethiopia. J AIDS HIV Res September 2014;6(8):164–170. Ejeta E, Birhanu T, Wolde T. Tuberculosis treatment outcomes among tuberculosis/human immunodeficiency co-infected cases treated under directly observed treatment of short course in Western Ethiopia. J AIDS HIV Res September 2014;6(8):164–170.
32.
go back to reference Ako A, Agbor J, Bigna JR, Billong SC, Tejiokem MC, Ekali GL, Plottel CS, et al. factors associated with death during tuberculosis treatment of patients co-infected with HIV at the Yaounde´ central hospital, Cameroon: an 8-year hospital-based retrospective cohort study (2006–2013). PLoS One. 2014;9(12):1–22. Ako A, Agbor J, Bigna JR, Billong SC, Tejiokem MC, Ekali GL, Plottel CS, et al. factors associated with death during tuberculosis treatment of patients co-infected with HIV at the Yaounde´ central hospital, Cameroon: an 8-year hospital-based retrospective cohort study (2006–2013). PLoS One. 2014;9(12):1–22.
33.
go back to reference Tabarsi P, Chitsaz E, Moradi A, Baghaei P, Marjani M, Mansouri D. Treatment outcome and mortality: their predictors among HIV/TB co-infected patients from Iran. Int J MycobacterIology. 2012;1:82–6.CrossRef Tabarsi P, Chitsaz E, Moradi A, Baghaei P, Marjani M, Mansouri D. Treatment outcome and mortality: their predictors among HIV/TB co-infected patients from Iran. Int J MycobacterIology. 2012;1:82–6.CrossRef
34.
go back to reference Oshi DC, Oshi SN, Alobu I, Ukwaja KN. Profile, outcomes, and determinants of unsuccessful tuberculosis treatment outcomes among HIV-infected tuberculosis patients in a Nigerian state. Hindawi Publishing Corporation Tuberculosis Res Treat 2014;2014:1–8.CrossRef Oshi DC, Oshi SN, Alobu I, Ukwaja KN. Profile, outcomes, and determinants of unsuccessful tuberculosis treatment outcomes among HIV-infected tuberculosis patients in a Nigerian state. Hindawi Publishing Corporation Tuberculosis Res Treat 2014;2014:1–8.CrossRef
35.
go back to reference Shastri S, Nagaraja SB, Tripathy JP, Satyanarayana S, Rewari BB. Predictors and timing of ATT initiation among HIV-TB patients at ART centers of Karnataka. India: Two Year Follow-Up PLoS ONE. 2015;10(09):1–11. Shastri S, Nagaraja SB, Tripathy JP, Satyanarayana S, Rewari BB. Predictors and timing of ATT initiation among HIV-TB patients at ART centers of Karnataka. India: Two Year Follow-Up PLoS ONE. 2015;10(09):1–11.
36.
go back to reference Huyen TTT, Nhung NV, Shewade HD, Hoa NB, Harries AD. Collaborative activities and treatment outcomes in patients with HIV-associated tuberculosis in Viet Nam. Public Health Action. March 2016;6(1):8 - `15.CrossRef Huyen TTT, Nhung NV, Shewade HD, Hoa NB, Harries AD. Collaborative activities and treatment outcomes in patients with HIV-associated tuberculosis in Viet Nam. Public Health Action. March 2016;6(1):8 - `15.CrossRef
37.
go back to reference Gebremariam G, Asmamaw G, Hussen M, Hailemariam MZ, Asegu D, Astatkie A, et al. Impact of HIV status on treatment outcome of tuberculosis patients registered at Arsi Negele Health center, southern Ethiopia: a six-year retrospective study. PLoS One. 2016;11:1–11.CrossRef Gebremariam G, Asmamaw G, Hussen M, Hailemariam MZ, Asegu D, Astatkie A, et al. Impact of HIV status on treatment outcome of tuberculosis patients registered at Arsi Negele Health center, southern Ethiopia: a six-year retrospective study. PLoS One. 2016;11:1–11.CrossRef
38.
go back to reference Ambadekar NN, Zodpey SP, Soni RN, Lanjewar SP. Treatment outcome and its attributes in TB-HIV co-infected patients registered under the revised national TB control program: a retrospective cohort analysis. Public Health. 2015;129:783–8.CrossRef Ambadekar NN, Zodpey SP, Soni RN, Lanjewar SP. Treatment outcome and its attributes in TB-HIV co-infected patients registered under the revised national TB control program: a retrospective cohort analysis. Public Health. 2015;129:783–8.CrossRef
39.
go back to reference Vijay S, Kumar P, Chauhan LS, Rao SVN, Vaidyanathan P. Treatment outcome and mortality at one and half year follow-up of HIV infected TB patients under TB control Programme in a district of South India. PLoS One. July 2011;6(7):1–8.CrossRef Vijay S, Kumar P, Chauhan LS, Rao SVN, Vaidyanathan P. Treatment outcome and mortality at one and half year follow-up of HIV infected TB patients under TB control Programme in a district of South India. PLoS One. July 2011;6(7):1–8.CrossRef
40.
go back to reference Engelbrecht MC, Kigozi NG, Chikobvu P, Botha S. Rensburg HCJv. Unsuccessful TB treatment outcomes with a focus on HIV co-infected cases: a cross-sectional retrospective record review in a high-burdened province of South Africa. BMC Health Serv Res. 2017;17(470):1–10. Engelbrecht MC, Kigozi NG, Chikobvu P, Botha S. Rensburg HCJv. Unsuccessful TB treatment outcomes with a focus on HIV co-infected cases: a cross-sectional retrospective record review in a high-burdened province of South Africa. BMC Health Serv Res. 2017;17(470):1–10.
41.
go back to reference Warkari PD, Nakel MP, Mahajan SM, Adchitre SA. Study of treatment outcome of tuberculosis among HIV co-infected patients: a cross-sectional study in Aurangabad city, Maharashtra. Int J Commun Med Public Health. 2017;4(12):4466–71.CrossRef Warkari PD, Nakel MP, Mahajan SM, Adchitre SA. Study of treatment outcome of tuberculosis among HIV co-infected patients: a cross-sectional study in Aurangabad city, Maharashtra. Int J Commun Med Public Health. 2017;4(12):4466–71.CrossRef
42.
go back to reference Refera H, Wencheko E. Survival of HIV-TB co-infected adult patients under ART in ambo referral hospital. Ethiop Ethiop J Health Dev. 2013;27(2):88–93. Refera H, Wencheko E. Survival of HIV-TB co-infected adult patients under ART in ambo referral hospital. Ethiop Ethiop J Health Dev. 2013;27(2):88–93.
43.
go back to reference Sileshi B, Deyessa N, Girma B, Melese M, Suarez P. Predictors of mortality among TB-HIV co-infected patients being treated for tuberculosis in Northwest Ethiopia: a retrospective cohort study. BMC Infect Dis. 2013;13(297):1–10. Sileshi B, Deyessa N, Girma B, Melese M, Suarez P. Predictors of mortality among TB-HIV co-infected patients being treated for tuberculosis in Northwest Ethiopia: a retrospective cohort study. BMC Infect Dis. 2013;13(297):1–10.
44.
go back to reference Gesesew H, Tsehayneh B, Massa D, Gebremedhin A, Kahsay H, Mwanri L. Predictors of mortality in a cohort of tuberculosis/HIV co-infected patients in Southwest Ethiopia. Infect Dis Poverty. 2016;5(109):1–9. Gesesew H, Tsehayneh B, Massa D, Gebremedhin A, Kahsay H, Mwanri L. Predictors of mortality in a cohort of tuberculosis/HIV co-infected patients in Southwest Ethiopia. Infect Dis Poverty. 2016;5(109):1–9.
45.
go back to reference Shastri S, Naik B, Shet A, Rewari B, Costa AD. TB treatment outcomes among TB-HIV co-infections in Karnataka, India: how do these compare with non-HIV tuberculosis outcomes in the province? BMC Public Health. 2013;13(838):1–6. Shastri S, Naik B, Shet A, Rewari B, Costa AD. TB treatment outcomes among TB-HIV co-infections in Karnataka, India: how do these compare with non-HIV tuberculosis outcomes in the province? BMC Public Health. 2013;13(838):1–6.
Metadata
Title
Treatment Outcome of Tuberculosis and Associated Factors among TB-HIV Co-Infected Patients at Public Hospitals of Harar Town, Eastern Ethiopia. A five-year retrospective study
Authors
Assefa Tola
Kirubel Minsamo Mishore
Yohanes Ayele
Abraham Nigussie Mekuria
Nanati Legese
Publication date
01-12-2019
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2019
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-019-7980-x

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