Associated factors with unsuccessful tuberculosis treatment outcomes among tuberculosis/HIV coinfected patients with drug-resistant tuberculosis

Abstract

Background: In Sub-Saharan Africa, HIV endemic has substantially contributed to the increasing tuberculosis (TB) incidence. The joint effect of the HIV and TB pestilences has confronted the feeble systems of healthcare in resource-limited countries. Methods: The aim of this study was to determine the pathological attributes, outcomes of TB treatment, and the contributing factors of unsuccessful results among TB/HIV patients. A retrospective cohort study of all confirmed adult TB/HIV coinfected hospitalized patients with drug-resistant TB reported for the treatment in two different hospitals from 2010 to 2016 in Eastern Cape, South Africa. Cox proportional hazard model was used in identifying the predictors of unsuccessful treatment. Results: Unsuccessful treatment outcomes among TB/HIV coinfected patients with treatment category were (95% confidence interval [CI]: 0.988–1.318) age, smoking (1.047; 95% CI: 0.892–1.229), pregnancy (1.940; 95% CI: 0.793–4.743), CD 4+ count (1.163; 95% CI: 0.993–1.361), and patients with comorbidity diseases such as diabetes, liver diseases, renal failure, hepatitis, and silicosis were all significantly associated with unsuccessful treatment. The preantiretroviral treatment (ART) females appear to have significantly better survival than pre-ART males. Conclusion: The study showed that the unsuccessful treatment outcomes among TB/HIV coinfected patients were slightly below the WHO target. The key predictors of unsuccessful TB treatment outcomes among the TB/HIV coinfected patients were associated with pregnancy, productive age group, gender, contraception, and comorbidity diseases.

Keywords

• Cox model
• hazard function
• hepatitis
• infection
• mortality rate
• survival pattern