Results of rapid and successful integration of HIV diagnosis and care into tuberculosis services in Benin
| Autor: | F. Boillot, Riitta A Dlodlo, Arnaud Trébucq, Capo-Chichi D, Ferroussier O, P. I. Fujiwara, Gninafon M |
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| Rok vydání: | 2013 |
| Předmět: |
Pulmonary and Respiratory Medicine
Adult Counseling Male Pediatrics medicine.medical_specialty Tuberculosis Time Factors Adolescent Anti-HIV Agents HIV diagnosis Human immunodeficiency virus (HIV) Antitubercular Agents Developing country HIV Infections medicine.disease_cause Treatment experienced Health Services Accessibility Young Adult Predictive Value of Tests Trimethoprim Sulfamethoxazole Drug Combination medicine Antiretroviral treatment Benin Humans Registries Program Development Aged Retrospective Studies Health Services Needs and Demand business.industry Coinfection Delivery of Health Care Integrated Retrospective cohort study Middle Aged medicine.disease Infectious Diseases Treatment Outcome Female CD4 Lymphocyte business Program Evaluation |
| Zdroj: | The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease. 17(11) |
| ISSN: | 1815-7920 |
| Popis: | SETTING: Benin where 20 of 54 tuberculosis (TB) clinics caring for 80% of all TB patients began providing integrated human immunodeficiency virus (HIV) care in 2005. OBJECTIVE: To describe the characteristics and TB treatment outcomes of the first cohorts of TB-HIV patients and to assess programmatic outcomes. METHODS: Retrospective cohort study using data from the TB register and the register of co-infected patients. RESULTS: During the study period 8368 TB patients were registered 7787 (93%) were tested for HIV and 1255 (16%) were HIV-positive including 385 (32%) who already knew their positive status. Most patients (88%) were tested within 15 days of TB diagnosis. Female and young patients were overrepresented among the co-infected. Cotrimoxazole preventive therapy was administered to 1152 patients (95%) during anti-tuberculosis treatment and antiretroviral treatment (ART) to 469 (42%). The likelihood of receiving ART increased as initial CD4 lymphocyte counts decreased. Fifteen per cent of TB-HIV patients died during anti-tuberculosis treatment. Patients already on ART prior to anti-tuberculosis treatment experienced the worst outcomes. Patients who initiated ART early during anti-tuberculosis treatment or in the timeframe recommended by the guidelines fared the best. CONCLUSION: HIV care has been successfully and sustainably integrated into TB services in Benin. However ensuring the access of co-infected patients to more favourable treatment outcomes still represents significant challenges. |
| Databáze: | OpenAIRE |
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