Tertiary-care Management of TB/HIV Co-infection in Port Harcourt, Nigeria: A Retrospective Cohort Analysis
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Background
Monitoring the treatment of tuberculosis(TB) and human immunodeficiency virus(HIV) co-infection is very important to improve patient management and compliance. This study assessed the treatment outcomes of registered TB/HIV co-infected patients enrolled in the Directly Observed Treatment Short course(DOTS) program.
Methods
A retrospective study was conducted in a tertiary-care hospital in Port Harcourt, Nigeria from January 1, 2014 to December 31, 2019. Data were extracted from the National TB program register and analyzed using the statistical software package(IBM SPSS version30.0). Bivariate and multivariate logistic regressions were used to identify factors associated with treatment outcomes at 95% confidence intervals.
Results
Among 305(37.4%) TB/HIV co-infected patients, the mean age was 29.2years, with 29.8% in the 0-14 age group, 89.5% new cases, and 89.2% pulmonary TB(PTB) cases. Males(50.2%) slightly outnumbered females(49.8%). Antiretroviral therapy(ART) and cotrimoxazole preventive therapy(CPT) uptake were high(95.1% and 93.4%, respectively). Treatment outcomes were: 19.0% cured, 23.3% completed treatment, 0.3% failed treatment, 23.6% died, 14.8% lost to follow-up, 10.8% transferred out, and 8.2% not evaluated. Overall, treatment success rate was 52.2%. Age(15-24 years: AOR=6.35, 95%CI:1.56-25.86; 25-34 years: AOR=3.97, 95%CI:1.37-11.45; and 45-54 years: AOR=6.40, 95%CI:2.27-18.06) and alternative diagnostic method(AOR=0.32, 95%CI:0.12-0.76) were significantly associated with unsuccessful treatment outcomes.
Conclusion
The treatment success rate of TB/HIV co-infected patients was relatively low and fell below the WHO target despite high uptake of ART and CPT. Study underscores the need for integrating targeted interventions, including alternative diagnostic methods, into clinical practice and policy to improve treatment outcomes among TB/HIV co-infected patients, particularly in specific age groups.
