High mortality in tuberculosis patients despite HIV interventions in Swaziland

G Mchunu, J van Griensven, S G Hinderaker, W Kizito, W Sikhondze, M Manzi, T Dlamini, A D Harries

Research output: Contribution to journalA2: International peer reviewed article (not A1-type)

Abstract

SETTING: All health facilities providing tuberculosis (TB) care in Swaziland.

OBJECTIVE: To describe the impact of human immunodeficiency virus (HIV) interventions on the trend of TB treatment outcomes during 2010-2013 in Swaziland; and to describe the evolution in TB case notification, the uptake of HIV testing, antiretroviral therapy (ART) and cotrimoxazole preventive therapy (CPT), and the proportion of TB-HIV co-infected patients with adverse treatment outcomes, including mortality, loss to follow-up and treatment failure.

DESIGN: A retrospective descriptive study using aggregated national TB programme data.

RESULTS: Between 2010 and 2013, TB case notifications in Swaziland decreased by 40%, HIV testing increased from 86% to 96%, CPT uptake increased from 93% to 99% and ART uptake among TB patients increased from 35% to 75%. The TB-HIV co-infection rate remained around 70% and the proportion of TB-HIV cases with adverse outcomes decreased from 36% to 30%. Mortality remained high, at 14-16%, over the study period, and anti-tuberculosis treatment failure rates were stable over time (<5%).

CONCLUSION: Despite high CPT and ART uptake in TB-HIV patients, mortality remained high. Further studies are required to better define high-risk patient groups, understand the reasons for death and design appropriate interventions.

Original languageEnglish
JournalPublic Health Action
Volume6
Issue number2
Pages (from-to)105-110
Number of pages6
ISSN2220-8372
DOIs
Publication statusPublished - 2016

Keywords

  • Journal Article

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