Treatment outcome of newly diagnosed sputum positive adult tuberculosis cases in the context of HIV infection

Abstract

Nigeria is one of the highest burdened tuberculosis (TB) countries and HIV co-infection poses a challenge in the control efforts of the national programme. Treatment outcome in newly diagnosed smear positive pulmonary TB cases, associated factors and outcome in relation to HIV infection were determined. A 5-year retrospective cross sectional study was carried out on category 1 TB cases at the University College Hospital, Ibadan, Nigeria. International definitions were used to assess outcome. A total of 857 cases were assessed, 75.6% were within the 20 to 49 years age category and 447 (52.2%) were males. A large percentage (46.8%) had (+) of AFB in the sputum, 24.1% was underweight and 199(23.2%) were HIV positive. The overall treatment success rate was 74.4%, 18(2.1%) defaulted, 22(2.6%) failed treatment and 48(5.6%) died. HIV positive cases were more likely to have treatment failure (10.6% vs.0.2%) and higher mortality (4.9% vs. 0.7%) (p = 0.01). All the defaulted cases were HIV negative. The overall TB treatment success rate was good but fell short of the 85% target. HIV co-infection was associated with a poorer outcome. A more community oriented programme, early identification and treatment of HIV are essential to improve treatment outcome.                                             Key words: Pulmonary TB, adults, outcome, DOTS, HIV co-infection, Nigeria.