Risk factors for prevalent tuberculosis in HIV-infected patients attending a fee-for-service HIV clinic in inner city Johannesburg, South Africa
| Autor: | Connell, Lucy Shirley |
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| Jazyk: | angličtina |
| Rok vydání: | 2014 |
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| Druh dokumentu: | Diplomová práce |
| Popis: | A research report submitted in partial fulfillment of the requirements for the degree of Master of Science in Epidemiology and Biostatistics University of the Witwatersrand, Faculty of Health Sciences, School of Public Health May, 2014 Introduction HIV-associated TB is curable with standard TB therapy and yet it is the leading cause of illness and death in patients infected with HIV. Coinfection with HIV poses considerable challenges to early diagnosis of TB in HIV-infected people and diagnostic delay and the rapidly progressive TB associated with HIV results in rapid clinical deterioration and increased mortality. There is an urgent need for research to identify risk factors for TB in HIV-infected people in order to refine diagnostic algorithms for the early and accurate diagnosis of tuberculosis in HIV-positive patients. The aim of this study was to determine the prevalence of TB, and identify factors associated with prevalent TB in HIV-infected adults paying a subsidized, all-inclusive monthly fee for HIV care in a private setting in downtown Johannesburg – a unique sub-population. Material and Methods This study was a retrospective, cross-sectional, secondary analysis of data extracted from the routine electronic medical records of HIV-infected adults who attended ZuziMpilo from August 2009 to December 2011. The outcome of interest was prevalent TB at the time of enrollment into care and exposures included age, sex, ethnicity, CD4 count, WHO Clinical Stage, BMI, alcohol and tobacco use history, level of education, employment status, monthly income, monthly cell phone expenditure, medical insurance status, source of funding for HIV care and source of knowledge about ZuziMpilo Medical Centre. Multivariable logistic regression modeling was used to determine risk factors for prevalent TB at the time of enrollment. Results Approximately 8 out of every 100 HIV-infected adults enrolling at ZuziMpilo from August 2009 to December 2011 had prevalent TB disease (8.24%). Significant predictors for prevalent TB included BMI categorised as non-obese, CD4 count |
| Databáze: | Networked Digital Library of Theses & Dissertations |
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