Outcomes of tuberculosis patients who start antiretroviral therapy under routine programme conditions in Malawi
AuthorsMakombe, S D
Harries, A D
Yu, J K-L
Schouten, E J
AffiliationClinical HIV Unit, Ministry of Health, Lilongwe 3, Malawi; Family Health International, Malawi Country Office, Lilongwe, Malawi; London School of Hygiene and Tropical Medicine, London, UK; Taiwan Medical Mission, Mzuzu Central Hospital, Mzuzu, Malawi; US Centres for Disease Control and Prevention, Malawi Office, Lilongwe, Malawi; Lighthouse Clinic, Lilongwe, Malawi; Médecins sans Frontieres, Brussels, Belgium; Thyolo District Hospital, Thyolo, Malawi; Ministry of Health, Lilongwe, Malawi; Management Sciences for Health, Lilongwe, Malawi
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AbstractSETTING: Public sector facilities in Malawi providing antiretroviral therapy (ART) to human immunodeficiency virus (HIV) positive patients, including those with tuberculosis (TB). OBJECTIVES: To compare 6-month and 12-month cohort treatment outcomes of HIV-positive TB patients and HIV-positive non-TB patients treated with ART. DESIGN: Retrospective data collection using ART patient master cards and ART patient registers. RESULTS: Between July and September 2005, 7905 patients started ART, 6967 with a non-TB diagnosis and 938 with a diagnosis of active TB. 6-month cohort outcomes of non-TB and TB patients censored on 31 March 2006 showed significantly more TB patients alive and on ART (77%) compared with non-TB patients (71%) (P < 0.001). Between January and March 2005, 4580 patients started ART, 4179 with a non-TB diagnosis and 401 with a diagnosis of active TB. 12-month cohort outcomes of non-TB and TB patients censored on 31 March 2006 showed significantly more TB patients alive and on ART (74%) compared with non-TB patients (66%) (P < 0.001). Other outcomes of default and transfer out were also significantly less frequent in TB compared with non-TB patients. CONCLUSION: HIV-positive TB patients on ART in Malawi have generally good treatment outcomes, and more patients need to access this HIV treatment.
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