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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Tuberculosis in HIV programmes in lower-income countries: Practices and risk factors
International Journal of Tuberculosis and Lung Disease, Volume 15, No. 5, Year 2011
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Description
BACKGROUND: Tuberculosis (TB) is a common diagnosis in human immunodeficiency virus (HIV) infected patients on antiretroviral treatment (ART). OBJECTIVE: To describe TB-related practices in ART programmes in lower-income countries and identify risk factors for TB in the first year of ART. METHODS: Programme characteristics were assessed using standardised electronic questionnaire. Patient data from 2003 to 2008 were analysed and incidence rate ratios (IRRs) calculated using Poisson regression models. RESULTS: Fifteen ART programmes in 12 countries in Africa, South America and Asia were included. Chest X-ray, sputum microscopy and culture were available free of charge in respectively 13 (86.7%), 14 (93.3%) and eight (53.3%) programmes. Eight sites (53.3%) used directly observed treatment and five (33.3%) routinely administered isoniazid preventive treatment (IPT). A total of 19 413 patients aged ≥16 years contributed 13 227 person-years of follow-up; 1081 new TB events were diagnosed. Risk factors included CD4 cell count (>350 cells/μl vs. <25 cells/μl, adjusted IRR 0.46, 95%CI 0.33-0.64, P < 0.0001), sex (women vs. men, adjusted IRR 0.77, 95%CI 0.68-0.88, P = 0.0001) and use of IPT (IRR 0.24, 95%CI 0.19-0.31, P < 0.0001). CONCLUSIONS: Diagnostic capacity and practices vary widely across ART programmes. IPT prevented TB, but was used in few programmes. More efforts are needed to reduce the burden of TB in HIV co-infected patients in lower income countries. © 2011 The Union.
Authors & Co-Authors
Fenner, Lukas
Switzerland, Bern
University of Bern
Forster, Mathieu
Switzerland, Bern
University of Bern
Boulle, Andrew
South Africa, Cape Town
Khayelitsha Art Programme
Phiri, Sam John Peter
Malawi, Lilongwe
Lighthouse Trust
Braitstein, Paula K.A.
Kenya, Eldoret
Moi University
Lewden, Charlotte
France, Bordeaux
Université de Bordeaux
France, Paris
Inserm
Schechter, Mauro T.
Brazil, Rio de Janeiro
Universidade Federal do Rio de Janeiro
Kumarasamy, Nagalingeswaran
India, Chennai
Yr Gaitonde Centre for Aids Research and Education
Pascoe, Margaret J.
Zimbabwe, Harare
Newlands Clinic
Sprinz, Eduardo
Brazil, Porto Alegre
Hospital de Clinicas de Porto Alegre
Bangsberg, David R.
Uganda, Mbarara
Immune Suppression Syndrome Clinic Iss
Sow, Papa Salif
Senegal, Dakar
Anrs 1290 Study Group
Dickinson, Diana B.
Botswana, Gaborone
Independence Surgery
Fox, Matthew P.
South Africa, Johannesburg
University of the Witwatersrand Faculty of Health Sciences
United States, Boston
School of Public Health
United States, Boston
Boston University
McIntyre, James Alasdair
South Africa, Johannesburg
Perinatal Hiv Research Unit
Khongphatthanayothin, Mana
Thailand, Bangkok
Thai Red Cross Agency
Dabis, Franćois Ç.Ois
France, Bordeaux
Université de Bordeaux
France, Paris
Inserm
Brinkhof, Martin W.G.
Switzerland, Bern
University of Bern
Wood, Robin Y.
South Africa, Cape Town
Gugulethu Art Programme
Egger, Matthias
Switzerland, Bern
University of Bern
Statistics
Citations: 40
Authors: 20
Affiliations: 19
Identifiers
Doi:
10.5588/ijtld.10.0249
ISSN:
10273719
Research Areas
Health System And Policy
Infectious Diseases
Study Design
Cohort Study
Participants Gender
Male
Female