Treatment outcomes of tuberculosis among people living with HIV/AIDS: A comparative assessment of primary and tertiary healthcare centres in Nasarawa State, Nigeria
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One of the Sustainable Development Goals for 2030 is to end the global TB epidemic. Translating this laudable target to reality requires strengthening collaborative tuberculosis/human Immunodeficiency Virus (TB/HIV) care at all levels to end TB in Nigeria. This study assessed the treatment outcomes of TB among people living with HIV (PLWH) and compared the treatment outcomes of TB between primary and tertiary healthcare facilities in Nasarawa State, Nigeria.
This facility-based retrospective survey of TB patients living with HIV was conducted in two tertiary healthcare facilities and a primary healthcare centre (PHC). Records of eligible patients who completed treatment between January 2016 and December 2019 were abstracted using a data pro forma. Treatment outcomes were categorized as either successful or unsuccessful. Descriptive and inferential analyses were conducted, in addition to multivariate logistic regression.
A total of 959 patients with a mean age of 33±14 years were evaluated; there were 847 adults (88.3%), and the proportion of females was 499 (52%). The proportion of patients who completed TB treatment was 26%; 20.5% were cured, while the mortality rate was 9.2%. The treatment success rate (TSR) was 46.5%; tertiary healthcare facilities had the highest unsuccessful treatment rates compared to the PHC. The TSR declined steadily from 68.8% in 2016 to 57.6% in 2019. Being treated at a tertiary healthcare facility (AOR=3.6, CI; 2.0-6.6) predicted successful treatment outcomes of TB among PLWH.
TB’s overall TSR among PLWH was low. Within the outcome categories, the proportion of patients who completed treatment and those cured compared better with unfavourable outcomes. The rate of unsuccessful TB treatment is highest in tertiary healthcare facilities compared to PHC. However, being treated in the tertiary healthcare facility predicted successful treatment outcomes, while treatment failure, death, and loss to follow-up were highest in the tertiary healthcare facilities.
