The treatment success rate and associated factors among pulmonary bacteriologically confirmed and pulmonary clinically diagnosed drug susceptible TB coinfected with HIV in Teso Sub-Region, North-Eastern Uganda 2020-2021. a retrospective study

2020-2021年乌干达东北部特索次区域合并HIV感染的肺结核(经细菌学确诊和临床诊断的药物敏感性结核病)患者的治疗成功率及其相关因素:一项回顾性研究

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Abstract

BACKGROUND: Tuberculosis (TB) remains a global public health burden, with 500,000 people dying of Tb in 2021. People living with HIV have an 18 times higher risk of having TB, which is associated with poor treatment outcomes. This study aimed to determine the treatment success rate and associated factors among Pulmonary Clinically Diagnosed and Bacteriologically Confirmed TB individuals coinfected with HIV in the Teso region, Northeastern Uganda. METHODS: We conducted a retrospective study in Twenty-two (22) accredited diagnostic and Tuberculosis Unit health facilities located in 11 districts of the Teso region, Northeastern. Data was collected from the health facility's Tb treatment register using a data abstraction tool in February 2024 for individuals with drug-susceptible tuberculosis who started Tb treatment from January 2020 to December 2021. Additional information relating to the patients was collected from the Client Care Cards. The primary outcome was treatment success (Yes and No). Continuous Data was summarized into mean and standard deviation and categorical variables into proportions and frequencies. Binary logistic regression analysis was conducted to determine factors associated with TSR and reported as adjusted odds ratios (aOR). A p < 0.05 was considered statistically significant. RESULTS: A total of 801 individuals were included in the analysis, with a median age of 42 years (interquartile range 33-52). Among these, 61.67% (n = 494) were aged 15-49. The majority of individuals, 53.43% (n = 428), were males, with 67.92% (n = 544) having PBC. Among all participants, 40.5% (n = 325) had been on treatment for more than 5 years. The Overall treatment success rate was 84.39%. Factors that were associated with successful TSR were receiving services at a specialized clinic (adjusted Odds Ratio (aOR) : 2.10, 95%CI; 1.03-4.23, P = 0.041), having New TB (aOR: 3.30, 95%CI; 1.17-9.39, P = 0.025) and relapsed TB (aOR: 9.71, 95%CI; 2.03-46.24, P = 0.004) and having viral load suppression (aOR :2.85, 95%CI; 1.64-4.97, P = 0.001). CONCLUSION: Receiving treatment in a specialized HIV clinic, having New and relapsed TB, and having a suppressed viral load were associated with a successful treatment rate. There is a need to scale up integrated TB/HIV differentiated services, ensure Viral load suppression through adherence support for the TB/HIV coinfected clients, and increase Tb awareness to achieve the end TB Strategy by 2030.

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