Tuberculosis preventive treatment opportunities at antiretroviral therapy initiation and follow-up visits.

Autor:	Agizew T; Centers for Disease Control and Prevention (CDC), Gaborone, Botswana.; Department of Family Medicine and Public Health, Faculty of Medicine, University of Botswana, Gaborone, Botswana.; School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa., Surie D; Division of Global HIV/AIDS and Tuberculosis, CDC, Atlanta, GA, USA., Oeltmann JE; Division of Global HIV/AIDS and Tuberculosis, CDC, Atlanta, GA, USA., Letebele M; Centers for Disease Control and Prevention (CDC), Gaborone, Botswana., Pals S; Division of Global HIV/AIDS and Tuberculosis, CDC, Atlanta, GA, USA., Mathebula U; Centers for Disease Control and Prevention (CDC), Gaborone, Botswana., Mathoma A; Centers for Disease Control and Prevention (CDC), Gaborone, Botswana., Kassa M; Department of Anaesthesia and Critical Care, University of Botswana, Gaborone, Botswana., Hamda S; Department of Family Medicine and Public Health, Faculty of Medicine, University of Botswana, Gaborone, Botswana., Pono P; Department of HIV/AIDS Prevention and Care, Ministry of Health and Wellness, Gaborone, Botswana., Rankgoane-Pono G; National Tuberculosis Control Programme, Ministry of Health and Wellness, Gaborone, Botswana., Boyd R; Centers for Disease Control and Prevention (CDC), Gaborone, Botswana.; Division of Tuberculosis Elimination, CDC, Atlanta, GA, USA., Auld A; Division of Global HIV/AIDS and Tuberculosis, CDC, Atlanta, GA, USA., Finlay A; Centers for Disease Control and Prevention (CDC), Gaborone, Botswana.; Division of Tuberculosis Elimination, CDC, Atlanta, GA, USA.
Jazyk:	angličtina
Zdroj:	Public health action [Public Health Action] 2020 Jun 21; Vol. 10 (2), pp. 64-69.
DOI:	10.5588/pha.19.0056
Abstrakt:	Setting: Twenty-two clinics providing HIV care and treatment in Botswana where tuberculosis (TB) and HIV comorbidity is as high as 49%. Objectives: To assess eligibility of TB preventive treatment (TPT) at antiretroviral therapy (ART) initiation and at four follow-up visits (FUVs), and to describe the TB prevalence and associated factors at baseline and yield of TB diagnoses at each FUV. Design: A prospective study of routinely collected data on people living with HIV (PLHIV) enrolled into care for the Xpert ® MTB/RIF Package Rollout Evaluation Study between 2012 and 2015. Results: Of 6041 PLHIV initiating ART, eligibility for TPT was 69% (4177/6041) at baseline and 93% (5408/5815); 95% (5234/5514); 96% (4869/5079); and 97% (3925/4055) at FUV1, FUV2, FUV3, and FUV4, respectively. TB prevalence at baseline was 11% and 2%, 3%, 3% and 6% at each subsequent FUV. At baseline, independent risk factors for prevalent TB were CD4 <200 cells/mm 3 (aOR = 1.4, P = 0.030); anemia (aOR = 2.39, P < 0.001); cough (aOR = 11.21, P < 0.001); fever (aOR = 2.15, P = 0.001); and weight loss (aOR = 2.60, P = 0.002). Conclusion: Eligibility for TPT initiation is higher at visits post-ART initiation, while most cases of active TB were identified at ART initiation. Missed opportunities for TB further compromises TB control effort among PLHIV in Botswana. Competing Interests: Conflicts of interest: none declared. (© 2020 The Union.)
Databáze:	MEDLINE
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