Voluntary counselling, HIV testing and adjunctive cotrimoxazole are associated with improved TB treatment outcomes under routine conditions in Thyolo District, Malawi


Chimzizi, R; Gausi, F; Bwanali, A; Mbalume, D; Teck, R; Gomani, P; Zachariah, R; Zuza, W; Malombe, R; Salaniponi, FM; Harries, AD; (2004) Voluntary counselling, HIV testing and adjunctive cotrimoxazole are associated with improved TB treatment outcomes under routine conditions in Thyolo District, Malawi. The international journal of tuberculosis and lung disease, 8 (5). pp. 579-85. ISSN 1027-3719

Full text not available from this repository.

Abstract

SETTING: Two rural districts in Malawi: Thyolo, where voluntary counselling and human immunodeficiency virus (HIV) testing (VCT) is offered to all tuberculosis (TB) patients and adjunctive cotrimoxazole to HIV positives, and Mulanje, where no such interventions are offered. OBJECTIVES: For all TB patients registered in 2001: 1) to determine the uptake of VCT and cotrimoxazole in Thyolo, and 2) to compare treatment outcomes between Thyolo and Mulanje. DESIGN: A cohort study using routinely collected programme data. RESULTS: There were 1239 TB patients in Mulanje and 1103 in Thyolo. In Thylo, 1064 (97%) patients consented to VCT, 1006 were HIV tested (91%) and 761 (69%) were started on cotrimoxazole a median of 4 days from registration; 77% of patients tested in Thyolo were HIV-positive. For all TB patients, in Thyolo and Mulanje, treatment success was respectively 75% and 61% (P < 0.001); death was 21% and 25% (P = 0.026); and other outcomes were 4% and 14% (P < 0.001). The adjusted relative risks of treatment success (1.23), death (0.84) and other outcomes (0.26) in Thyolo were significantly different from those in Mulanje (P < 0.001). CONCLUSION: VCT and adjunctive cotrimoxazole is well accepted by TB patients in Thyolo and, with other HIV care and support services, is associated with good treatment outcome indicators for the National Tuberculosis Programme. This intervention is being expanded to other districts in Malawi, and other African countries should consider a similar approach to the dual HIV-TB epidemic.

Item Type: Article
Keywords: AIDS Serodiagnosis, Adolescent, Adult, Aged, Aged, 80 and over, Anti-Infective Agents, Antitubercular Agents, Case-Control Studies, Child, Child, Preschool, Counseling, Drug Therapy, Combination, Female, Humans, Infant, Malawi, Male, Middle Aged, Patient Acceptance of Health Care, Treatment Outcome, Trimethoprim-Sulfamethoxazole Combination, Tuberculosis, Voluntary Programs, AIDS Serodiagnosis, Adolescent, Adult, Aged, Aged, 80 and over, Anti-Infective Agents, administration & dosage, Antitubercular Agents, administration & dosage, Case-Control Studies, Child, Child, Preschool, Counseling, Drug Therapy, Combination, Female, Humans, Infant, Malawi, Male, Middle Aged, Patient Acceptance of Health Care, Treatment Outcome, Trimethoprim-Sulfamethoxazole Combination, administration & dosage, Tuberculosis, therapy, Voluntary Programs
Faculty and Department: Faculty of Infectious and Tropical Diseases > Dept of Clinical Research
PubMed ID: 15137534
Web of Science ID: 221256300012
URI: http://researchonline.lshtm.ac.uk/id/eprint/8927

Statistics


Download activity - last 12 months
Downloads since deposit
0Downloads
296Hits
Accesses by country - last 12 months
Accesses by referrer - last 12 months
Additional statistics for this record are available via IRStats2

Actions (login required)

Edit Item Edit Item