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Prevalence, modes of management and treatment outcomes among patients with hiv/aids and tuberculosis co-infections in Dar es Salaam, 2005
Abstract
Objectives: To determine the prevalence, modes of management and treatment outcomes among patients with HIV/TB co-infection attending Dar-es-Salaam hospitals in 2005. Methodology: Retrospective, Cross-sectional hospital based study was conducted between 12th August to 23rd September 2005. Data were collected among patients attending VCT clinics at Muhimbili National Hospital and Mnazi Mmoja Hospital. The study included medical records of patients aged ≥8 years.
Results: HIV infected individuals had a higher (20.2%) prevalence of Tuberculosis compared to those who were
negative for HIV (3.2%). The most commonly used diagnostic methods included radiological tests, sputum smears and tuberculin skin tests. Sputum cultures were hardly done. Chest radiography was found to be atypical in most of the patients who were positive for HIV 17 (32.7%). Sputum smears were found to be negative among 10 (19.2%) of the patients who were positive for TB through other tests. Treatment for Tuberculosis and AIDS depends on the CD4 levels and that TB was treated first before HAART in the case where the CD4 were < 200 and anti-TB was administered for a short while until patients were stable. Most (90.9%) of patients with CD4 <50 were not on anti-TB therapy at the time of the study but they had a history of being treated for TB earlier before the start of ARVs. No side effects from the drug therapy were observed in all patients involved in this study. None among the study population died in the period of the study. Conclusion: In this study, TB infection was found to be significantly higher among patients who are HIV positive than not. Chest radiography was found to be atypical in most of the HIV infected patients. Recommendations: All HIV infected individuals should be tested for Tuberculosis prior to the initiation of ART in countries (like Tanzania) where tuberculosis is endemic. Several tests including chest x-ray and sputum cultures should be done to all individuals. This will result in early detection and treatment, and thus reduction of spread of disease.
Results: HIV infected individuals had a higher (20.2%) prevalence of Tuberculosis compared to those who were
negative for HIV (3.2%). The most commonly used diagnostic methods included radiological tests, sputum smears and tuberculin skin tests. Sputum cultures were hardly done. Chest radiography was found to be atypical in most of the patients who were positive for HIV 17 (32.7%). Sputum smears were found to be negative among 10 (19.2%) of the patients who were positive for TB through other tests. Treatment for Tuberculosis and AIDS depends on the CD4 levels and that TB was treated first before HAART in the case where the CD4 were < 200 and anti-TB was administered for a short while until patients were stable. Most (90.9%) of patients with CD4 <50 were not on anti-TB therapy at the time of the study but they had a history of being treated for TB earlier before the start of ARVs. No side effects from the drug therapy were observed in all patients involved in this study. None among the study population died in the period of the study. Conclusion: In this study, TB infection was found to be significantly higher among patients who are HIV positive than not. Chest radiography was found to be atypical in most of the HIV infected patients. Recommendations: All HIV infected individuals should be tested for Tuberculosis prior to the initiation of ART in countries (like Tanzania) where tuberculosis is endemic. Several tests including chest x-ray and sputum cultures should be done to all individuals. This will result in early detection and treatment, and thus reduction of spread of disease.
