Akanbi Kayode, Ajayi Ikeoluwapo, Fayemiwo Samuel, Gidado Saheed, Oladimeji Abisola, Nsubuga Peter
Nigeria Field Epidemiology and Laboratory Training Program, Haile Selassie, Asokoro, Abuja, Nigeria.
Department of Medical Microbiology and Parasitology, College of Medicine, University of Ibadan, Nigeria.
Pan Afr Med J. 2019 Jan 22;32(Suppl 1):7. doi: 10.11604/pamj.supp.2019.32.1.13272. eCollection 2019.
tuberculosis (TB) is the commonest opportunistic infection and cause of death in patients with Human Immunodeficiency Virus (HIV) in developing countries. World Health Organization (WHO) recommends 85% treatment success rate for all TB cases as an indicator of TB control. The study aimed at determining TB treatment success rate among TB-HIV co-infected patients and identifying predictors of successful treatment among patients in TB treatment sites in Abeokuta, Nigeria.
it was a cross-sectional study among HIV-TB co-infected patients in the two major health facilities in Abeokuta, Nigeria. Socio-demographic characteristics with treatment history were obtained using a semi-structured questionnaire. Sputum samples were collected and tested for acid-fast bacilli (AFB) using a standard method according to national guideline for TB treatment to determine treatment success rate. Treatment success was defined as any HIV positive patient with a diagnosis of TB by acid-fast bacilli (AFB) smear positivity at diagnosis, who after 6 months of complete treatment becomes smear negative. Adjusted odds ratio was used to identify independent predictors of successful treatment outcome with confidence interval set at 95% and level of significance set at P < 0.05.
a total of 109 HIV-TB co-infected patients were enrolled for this study. Fifty-nine (54.1%) were females, 106 (97.3%) were newly treated for TB. Eighty-five (78.0%) were treated in a private health facility. A total of 91 had successful treatment outcome with a treatment success rate (TSR) of 83.5%. Eleven (10.1%) died, 5 (4.6%) defaulted, 1 (0.9%) failed treatment, 1 (0.9%) was transferred out. Successful treatment was associated with being newly registered (i.e. receiving TB treatment under the DOTS program for the first time), receiving TB treatment for the first time (adjusted OR = 18, 95%CI: 1.5-482.3) and being treated at a private health facility (adjusted OR = 14.1, 95%CI 4.27-48.4).
treatment success rate of TB among HIV-TB co-infected patients in this study slightly falls below the WHO target. Registration status and health facility type were predictors of treatment outcome among study patients. Patients and healthcare workers in public facilities were educated on HIV-TB co-infection management.
在发展中国家，结核病是人类免疫缺陷病毒（HIV）感染者中最常见的机会性感染和死亡原因。世界卫生组织（WHO）建议将所有结核病病例85%的治疗成功率作为结核病控制的一项指标。本研究旨在确定结核病合并HIV感染患者的结核病治疗成功率，并找出尼日利亚阿贝奥库塔结核病治疗点患者治疗成功的预测因素。
这是一项针对尼日利亚阿贝奥库塔两家主要医疗机构中结核病合并HIV感染患者的横断面研究。采用半结构化问卷获取患者的社会人口学特征及治疗史。按照国家结核病治疗指南的标准方法收集痰液样本并检测抗酸杆菌（AFB），以确定治疗成功率。治疗成功定义为任何诊断为结核病且抗酸杆菌（AFB）涂片阳性的HIV阳性患者，在完成6个月治疗后涂片转阴。采用校正比值比来确定治疗成功结局的独立预测因素，置信区间设定为95%，显著性水平设定为P<0.05。
本研究共纳入109例结核病合并HIV感染患者。59例（54.1%）为女性，106例（97.3%）为新接受结核病治疗的患者。85例（78.0%）在私立医疗机构接受治疗。共有91例治疗成功，治疗成功率（TSR）为83.5%。11例（10.1%）死亡，5例（4.6%）失访，1例（0.9%）治疗失败，1例（0.9%）转出。治疗成功与新登记（即首次在直接观察下短程治疗（DOTS）项目下接受结核病治疗）、首次接受结核病治疗（校正OR=18，95%CI：1.5 - 482.3）以及在私立医疗机构接受治疗（校正OR=14.1，95%CI 4.27 - 48.4）相关。
本研究中结核病合并HIV感染患者的结核病治疗成功率略低于WHO目标。登记状态和医疗机构类型是研究患者治疗结局的预测因素。对公立医疗机构的患者和医护人员进行了结核病合并HIV感染管理方面的教育。
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