Treatment outcomes of tuberculosis among tb-hiv co-infected patients and associated factors in mizan-tepi university teaching hospital mizan-aman town south western Ethiopia. A retrospective cohort study

Abstract

Background: Tuberculosis treatment outcomes for HIV positive TB patients are worse than those for HIV-negative and TB-HIV co-infection is associated with poor TB treatment outcomes. Objective: To assess the outcomes of TB treatment among TB-HIV co-infected patients and associated factors in Mizan-Tepi University Teaching Hospital, Mizan-Aman town, South-Western Ethiopia. Methods: A hospital-based retrospective cohort study was conducted among 163 TB-HIV co-infected patients who registered from 2015 to 2020 in MTUTH, Mizan-Aman town. The data were collected through document review by using a structured data collection format. The data were analyzed using Statistical Package for Social Sciences (SPSS) version 20. Bivariable and Multivariable Cox proportional hazard regression analysis were used to determine the associated factors with the outcome. Adjusted hazard ratio with its corresponding 95% confidence interval was used to measure the strength of association and statistical significance respectively. Results: Of the 163 TB-HIV co-infected 27% of the participants were cured, 34.4% had completed their treatment, 14.7% were died and 23.9% were lost to follow-up. Overall, successful outcome among TB-HIV co-infected was 61.4%. Those patients who attended primary school (aHR= 4.48, 95% CI: 1.73-11.64), who had baseline weight between 40-55kg (aHR= 2.68, 95% CI: 1.40-5.13), pretreatment BMI <18.5kg/m2 (aHR= 3.21, 95% CI: 1.76-5.83) and history of opportunistic infections (aHR= 2.77, 95% CI: 1.29-5.91) were found statistically significantly associated with the outcomes of TB-HIV co-infected patients. Conclusion: The overall successful TB treatment outcome among TB-HIV co-infected patients in the current study was very low. Patients who attended primary school, weight (40-55 kg), low BMI (<18.5kg/m2) and experienced opportunistic infections were associated with outcomes of TB-HIV co-infected patients. Therefore, targeted measures should be considered to decrease poor TB treatment outcomes among exposed through careful monitoring, making the DOTs program more accessible, counseling, and linking HIV patients.