Associated factors at different treatment outcomes (cured, completed, defaulted, and death) among TB/HIV co-infected patients in East Coast Malaysia: 5-year record review (2016 - 2020)

Background Tuberculosis (TB) and human immunodeficiency virus (HIV) co-infection pose a substantial public health problem, particularly in high-prevalence areas. This study uses an epidemiological model to analyze the sociodemographic and clinical characteristics related to various TB treatment outcomes (cured, completed, defaulted, and death) among TB/HIV co-infected patients on the East Coast of Malaysia over five years. Methods This cross-sectional study used secondary data from the e-Notifikasi for Tuberculosis Information System (TBIS) from January 2016 to December 2020 and was conducted at the State TB Organizer or TB/Leprosy Unit, Jabatan Kesihatan Negeri (JKN) Kelantan, Terengganu, and Pahang. Data was analyzed using multinomial logistic regression with IBM SPSS Statistics version 25.0 and STATA-14. Ethics permission was received from the Medical Research Ethics Committee (MREC), Ministry of Health (MOH). Results There were 14,289 TB cases, with 1,292 (9.04%) being TB/HIV co-infected patients. However, 69 TB/HIV cases were excluded due to transfer, change of diagnosis, and still ongoing treatment. As a result, 1,223 TB/HIV co-infected patients were assessed. The prevalence of cured was 33.5% (410), completed 29.2% (357), defaulted 6.4% (78), and died 30.9% (378). There were no failures identified. Nine factors were determined to be statistically significant during the univariable analysis. The important variables discovered in the univariate study were then used for the multivariate analysis. The study found that the duration of treatment, diabetes mellitus, occupation, and Chest X-ray (CXR) status were all substantially linked with treatment completion. Age, duration of treatment, residency, Directly Observed Treatment Short-course (DOTS) status, case type, and CXR status significantly impacted treatment default. In contrast, duration of treatment, diabetes mellitus, DOTS, occupation, and CXR all had a substantial effect on death rates. Conclusion Understanding the factors that influence TB treatment outcomes is crucial for developing effective intervention strategies and enhancing patient outcomes. The findings of this study provide a comprehensive understanding of the relevant factors influencing treatment outcomes at all levels, which may aid in the development of more effective treatment techniques.