Antiretroviral Treatment Among Co-infected Tuberculosis Patients in Integrated and Non-integrated Facilities

Overview

Journal Public Health Action

Date 2015 Sep 25

PMID 26400380

Citations 2

Authors

T D Ledibane

S C Motlhanke

A Rose

W H Kruger

N R T Ledibane

M M Claassens

Affiliations

Soon will be listed here.

Abstract

Background: South Africa has the second worst tuberculosis-human immunodeficiency virus (TB-HIV) syndemic in the world: in 2011, the TB-HIV co-infection rate was estimated at 65%. Integration of TB and HIV health-care services was implemented to increase antiretroviral treatment (ART) uptake among eligible patients.

Aim: To evaluate whether integrated TB and HIV facilities had better ART uptake among eligible patients compared to non-integrated facilities.

Methods: A cross-sectional study using routine TB programme data from January to December 2010. ART eligibility was defined as a CD4+ cell count <350 cells/μl.

Results: Respectively 2761 (86.8%) and 3611 (84.7%) patients were eligible for ART at integrated and non-integrated facilities (P < 0.001). The proportion of patients started on ART at integrated facilities did not differ significantly from that of non-integrated facilities (35.9% vs. 37.1%, P = 0.340), but the proportion with unknown HIV status (31.8% vs. 24.5%, P < 0.001) and unknown CD4+ cell count (40.9% vs. 30.4%, P < 0.001) did.

Conclusion: Integration of TB and HIV services in the Free State (2009-2010) was not associated with improved ART uptake. The reasons why are not clear. Of concern are the high proportions of unknown HIV status and CD4+ cell count results, especially at integrated facilities, and the small proportion of patients on ART, which may indicate poor implementation of integration.

Citing Articles

Effect of TB/HIV Integration on TB and HIV Indicators in Rural Ugandan Health Facilities.

Burnett S, Zawedde-Muyanja S, Hermans S, Weaver M, Colebunders R, Manabe Y J Acquir Immune Defic Syndr. 2018; 79(5):605-611.

PMID: 30383587 PMC: 6422342. DOI: 10.1097/QAI.0000000000001862.

The patient costs of care for those with TB and HIV: a cross-sectional study from South Africa.

Mudzengi D, Sweeney S, Hippner P, Kufa T, Fielding K, Grant A Health Policy Plan. 2017; 32(suppl_4):iv48-iv56.

PMID: 28204500 PMC: 5886108. DOI: 10.1093/heapol/czw183.

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