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Tuberculosis Incidence and Mortality Rates Among People Living with HIV Receiving Antiretroviral Therapy at the Buea Regional Hospital: A Seven Year Retrospective Study

Received: 20 May 2019     Accepted: 25 June 2019     Published: 31 July 2019
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Abstract

Introduction: The use of antiretroviral therapy (ART) has dramatically decreased HIV-associated morbidity and mortality in high-and low-income countries with a corresponding reduction in tuberculosis (TB) incidence. Nevertheless, the risk of TB remains substantially higher in people living with HIV (PLHIV) compared to non-HIV infected individuals. In Cameroon, free ART was introduced in 2007 and our understanding of the possible role of ART in reducing HIV-associated TB remains limited. We assessed TB incidence, mortality and risk factors for TB and mortality among PLHIV treated at Buea Regional Hospital between 2008 and 2014. Materials and Methods: In a retrospective study we reviewed the records of 1,477 HIV patients on ART. The data was entered and analysed using SPSS version 21. Bivariate and Multivariate logistic regression analysis were used to determine the risk factors associated with TB and mortality occurrences at 5% significance level. Results: Of the 1477 patients’ records that was reviewed, females (70.7%) constituted a greater proportion. Majority of the participants (60.5%) were between the ages 21-40 years (mean: 37.5 ± 11.5. SD). A total of 209 patients developed TB giving an overall TB incidence density rate 4.25/100PYR (95% CI: 2.47-6.46). There was an increasing trend in the incidence of TB over the years from 1.69 (95% CI: 0.72-1.98) in 2008 to 19.63 (95% CI: 7.36-21.20) in 2014. The overall mortality rate was 12.4% (183/1477) of which 38.8% (71/183) of them were on TB treatment or previously treated for TB. In a multivariate analysis, low CD4 cells level at ART initiation (AOR: 1.3, 95% CI: 1.11-.2.10), WHO HIV clinical stage 3 and 4 (AOR: 1.52, 95% CI: 1.01-2.22) were significantly associated with increase odds of TB occurrence. Conclusion: Even in the era of HAART, TB still remains a significant cause of mortality among PLHIV and therefore efforts should be scaled-up for early diagnosis and prompt treatment of TB.

Published in International Journal of HIV/AIDS Prevention, Education and Behavioural Science (Volume 5, Issue 2)
DOI 10.11648/j.ijhpebs.20190502.11
Page(s) 82-90
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This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2019. Published by Science Publishing Group

Keywords

Antiretroviral Therapy, Incidence, Mortality, Tuberculosis, PLHIV

References
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  • APA Style

    Henry Dilonga Meriki, Kah Emmanuel Nji, Kukwah Anthony Tufon, Yaoh Adolf Tah, Pascal Nji Atanga, et al. (2019). Tuberculosis Incidence and Mortality Rates Among People Living with HIV Receiving Antiretroviral Therapy at the Buea Regional Hospital: A Seven Year Retrospective Study. International Journal of HIV/AIDS Prevention, Education and Behavioural Science, 5(2), 82-90. https://doi.org/10.11648/j.ijhpebs.20190502.11

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    ACS Style

    Henry Dilonga Meriki; Kah Emmanuel Nji; Kukwah Anthony Tufon; Yaoh Adolf Tah; Pascal Nji Atanga, et al. Tuberculosis Incidence and Mortality Rates Among People Living with HIV Receiving Antiretroviral Therapy at the Buea Regional Hospital: A Seven Year Retrospective Study. Int. J. HIV/AIDS Prev. Educ. Behav. Sci. 2019, 5(2), 82-90. doi: 10.11648/j.ijhpebs.20190502.11

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    AMA Style

    Henry Dilonga Meriki, Kah Emmanuel Nji, Kukwah Anthony Tufon, Yaoh Adolf Tah, Pascal Nji Atanga, et al. Tuberculosis Incidence and Mortality Rates Among People Living with HIV Receiving Antiretroviral Therapy at the Buea Regional Hospital: A Seven Year Retrospective Study. Int J HIV/AIDS Prev Educ Behav Sci. 2019;5(2):82-90. doi: 10.11648/j.ijhpebs.20190502.11

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  • @article{10.11648/j.ijhpebs.20190502.11,
      author = {Henry Dilonga Meriki and Kah Emmanuel Nji and Kukwah Anthony Tufon and Yaoh Adolf Tah and Pascal Nji Atanga and Anna Longdoh Njunda and Irene Ane Anyangwe},
      title = {Tuberculosis Incidence and Mortality Rates Among People Living with HIV Receiving Antiretroviral Therapy at the Buea Regional Hospital: A Seven Year Retrospective Study},
      journal = {International Journal of HIV/AIDS Prevention, Education and Behavioural Science},
      volume = {5},
      number = {2},
      pages = {82-90},
      doi = {10.11648/j.ijhpebs.20190502.11},
      url = {https://doi.org/10.11648/j.ijhpebs.20190502.11},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijhpebs.20190502.11},
      abstract = {Introduction: The use of antiretroviral therapy (ART) has dramatically decreased HIV-associated morbidity and mortality in high-and low-income countries with a corresponding reduction in tuberculosis (TB) incidence. Nevertheless, the risk of TB remains substantially higher in people living with HIV (PLHIV) compared to non-HIV infected individuals. In Cameroon, free ART was introduced in 2007 and our understanding of the possible role of ART in reducing HIV-associated TB remains limited. We assessed TB incidence, mortality and risk factors for TB and mortality among PLHIV treated at Buea Regional Hospital between 2008 and 2014. Materials and Methods: In a retrospective study we reviewed the records of 1,477 HIV patients on ART. The data was entered and analysed using SPSS version 21. Bivariate and Multivariate logistic regression analysis were used to determine the risk factors associated with TB and mortality occurrences at 5% significance level. Results: Of the 1477 patients’ records that was reviewed, females (70.7%) constituted a greater proportion. Majority of the participants (60.5%) were between the ages 21-40 years (mean: 37.5 ± 11.5. SD). A total of 209 patients developed TB giving an overall TB incidence density rate 4.25/100PYR (95% CI: 2.47-6.46). There was an increasing trend in the incidence of TB over the years from 1.69 (95% CI: 0.72-1.98) in 2008 to 19.63 (95% CI: 7.36-21.20) in 2014. The overall mortality rate was 12.4% (183/1477) of which 38.8% (71/183) of them were on TB treatment or previously treated for TB. In a multivariate analysis, low CD4 cells level at ART initiation (AOR: 1.3, 95% CI: 1.11-.2.10), WHO HIV clinical stage 3 and 4 (AOR: 1.52, 95% CI: 1.01-2.22) were significantly associated with increase odds of TB occurrence. Conclusion: Even in the era of HAART, TB still remains a significant cause of mortality among PLHIV and therefore efforts should be scaled-up for early diagnosis and prompt treatment of TB.},
     year = {2019}
    }
    

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  • TY  - JOUR
    T1  - Tuberculosis Incidence and Mortality Rates Among People Living with HIV Receiving Antiretroviral Therapy at the Buea Regional Hospital: A Seven Year Retrospective Study
    AU  - Henry Dilonga Meriki
    AU  - Kah Emmanuel Nji
    AU  - Kukwah Anthony Tufon
    AU  - Yaoh Adolf Tah
    AU  - Pascal Nji Atanga
    AU  - Anna Longdoh Njunda
    AU  - Irene Ane Anyangwe
    Y1  - 2019/07/31
    PY  - 2019
    N1  - https://doi.org/10.11648/j.ijhpebs.20190502.11
    DO  - 10.11648/j.ijhpebs.20190502.11
    T2  - International Journal of HIV/AIDS Prevention, Education and Behavioural Science
    JF  - International Journal of HIV/AIDS Prevention, Education and Behavioural Science
    JO  - International Journal of HIV/AIDS Prevention, Education and Behavioural Science
    SP  - 82
    EP  - 90
    PB  - Science Publishing Group
    SN  - 2575-5765
    UR  - https://doi.org/10.11648/j.ijhpebs.20190502.11
    AB  - Introduction: The use of antiretroviral therapy (ART) has dramatically decreased HIV-associated morbidity and mortality in high-and low-income countries with a corresponding reduction in tuberculosis (TB) incidence. Nevertheless, the risk of TB remains substantially higher in people living with HIV (PLHIV) compared to non-HIV infected individuals. In Cameroon, free ART was introduced in 2007 and our understanding of the possible role of ART in reducing HIV-associated TB remains limited. We assessed TB incidence, mortality and risk factors for TB and mortality among PLHIV treated at Buea Regional Hospital between 2008 and 2014. Materials and Methods: In a retrospective study we reviewed the records of 1,477 HIV patients on ART. The data was entered and analysed using SPSS version 21. Bivariate and Multivariate logistic regression analysis were used to determine the risk factors associated with TB and mortality occurrences at 5% significance level. Results: Of the 1477 patients’ records that was reviewed, females (70.7%) constituted a greater proportion. Majority of the participants (60.5%) were between the ages 21-40 years (mean: 37.5 ± 11.5. SD). A total of 209 patients developed TB giving an overall TB incidence density rate 4.25/100PYR (95% CI: 2.47-6.46). There was an increasing trend in the incidence of TB over the years from 1.69 (95% CI: 0.72-1.98) in 2008 to 19.63 (95% CI: 7.36-21.20) in 2014. The overall mortality rate was 12.4% (183/1477) of which 38.8% (71/183) of them were on TB treatment or previously treated for TB. In a multivariate analysis, low CD4 cells level at ART initiation (AOR: 1.3, 95% CI: 1.11-.2.10), WHO HIV clinical stage 3 and 4 (AOR: 1.52, 95% CI: 1.01-2.22) were significantly associated with increase odds of TB occurrence. Conclusion: Even in the era of HAART, TB still remains a significant cause of mortality among PLHIV and therefore efforts should be scaled-up for early diagnosis and prompt treatment of TB.
    VL  - 5
    IS  - 2
    ER  - 

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Author Information
  • Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon

  • TB Diagnostic Unit, Regional Hospital Buea, Buea, Cameroon

  • Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon

  • Department of Public Health and Hygiene, University of Buea, Buea, Cameroon

  • Cameroon Baptist Convention Health Service, Mutengene, Cameroon

  • Department of Medical Microbiology and Parasitology, University of Buea, Buea, Cameroon

  • Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon

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