Abstract
BACKGROUND: Tuberculosis (TB) and human immunodeficiency virus (HIV) co-infection represent a significant public health challenge, especially in regions with high prevalence. This study employs an epidemiological model to examine the socio-demographic and clinical characteristics associated with different TB treatment outcomes such as cured, completed, defaulted, and death among TB/HIV co-infected patients on the East Coast of Malaysia over a five-year period. METHODS: This cross-sectional study utilised secondary data from the e-Notifikasi for Tuberculosis Information System (TBIS) from January 2016 to December 2020. The study was conducted at the State TB Organizer or TB/Leprosy Unit, Jabatan Kesihatan Negeri (JKN) in Kelantan, Terengganu, and Pahang. Data were analysed using multinomial logistic regression with IBM SPSS Statistics version 25.0 and STATA 14. Ethical permission was obtained from the Medical Research Ethics Committee (MREC) of the Ministry of Health (MOH). RESULTS: There were 14,289 TB cases, with 1,292 (9.04%) being TB/HIV co-infected patients. However, 69 TB/HIV cases were excluded due to transfer, change of diagnosis, and still ongoing treatment. As a result, 1,223 TB/HIV co-infected patients were assessed. The prevalence of cured was 33.5% (410), completed was 29.2% (357), defaulted was 6.4% (78), and died was 30.9% (378). There were no failures identified. In multivariate analysis, it was found that duration of treatment, diabetes mellitus, occupation, and Chest X-ray (CXR) status were substantially linked with treatment completion. Age, duration of treatment, residency, Directly Observed Treatment Short-course (DOTS) status, case category, and CXR status significantly impacted treatment default. In contrast, duration of treatment, diabetes mellitus, DOTS, occupation, and CXR had a substantial effect on the death outcome. CONCLUSION: Understanding the factors that influence TB treatment outcomes is crucial for developing effective intervention strategies and enhancing patient outcomes. The findings of this study provide a comprehensive understanding of the relevant factors influencing treatment outcomes at all levels, which may aid in the development of more effective treatment programs.