Decline in adverse outcomes and death in tuberculosis patients in Malawi: association with HIV interventions.
Kanyerere, H;
Mganga, A;
Harries, AD;
Tayler-Smith, K;
Zachariah, R;
Jahn, A;
Chimbwandira, FM;
Mpunga, J;
(2015)
Decline in adverse outcomes and death in tuberculosis patients in Malawi: association with HIV interventions.
Public health action, 5 (2).
pp. 116-118.
ISSN 2220-8372
DOI: https://doi.org/10.5588/pha.14.0109
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Between 2000 and 2012, the annual numbers of patients treated for tuberculosis (TB) in Malawi declined by 28%, from 28 234 to 20 463. During this time, the proportion of TB patients tested for the human immunodeficiency virus (HIV) increased from 6% to 87%. Most HIV-infected patients received cotrimoxazole preventive therapy, and the proportion receiving antiretroviral therapy increased to 88%. Between 2000 and 2008 there was a significant decline in all adverse outcomes (from 31% to 14%), and particularly in deaths (from 23% to 10%) and loss to follow-up (from 5.2% to 1.9%, P < 0.001). After 2008, there was no decrease in any adverse outcome. Ways to further reduce TB-associated mortality are discussed.
