SEARCHCOHORTinfectious disease, public health

cohort·infectious disease, public health, epidemiology, internal medicine, observational study·PMC10325059

Mortality rate and associated factors among patients co-infected with drug resistant tuberculosis/HIV at Mulago National Referral Hospital, Uganda, a retrospective cohort study

PLOS Global Public Health · 14 authors, 4 centres

AI SUMMARY

FIDELITY 100%

POPULATION390 persons on treatment with a DR-TB/HIV co-infection at Mulago National Referral Hospital, Uganda

INTERVENTIONNot a specific intervention; study assessed outcomes of standard care and associated factors.

COMPARISONBivariate and multivariate analysis of factors among the cohort.

This summary was generated by AI from a single paper. It has not been reviewed by a clinician and is not clinical advice. Verify against the source before acting on it.

AGENT 01 · STRUCTURED SUMMARY

TRACE TO SOURCE

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TL;DR

This retrospective cohort study examined mortality and associated factors in 390 patients co-infected with drug-resistant tuberculosis (DR-TB) and HIV in Uganda. It found a 33.2% mortality rate, with factors like ART initiation and having a BMI ≥18.5 kg/m² being protective against death.

Full summary

721 CHARS

This retrospective cohort study analyzed medical records for 390 patients with DR-TB/HIV co-infection at Mulago Hospital from January 2014 to December 2019. The primary outcome was mortality, with factors like ART initiation, BMI, and adverse events analyzed using modified Poisson regression. The study found a mortality rate of 33.2% (129/390 deaths). Limitations include reliance on existing data with missing variables like viral load, potential misclassification bias, and being conducted in a single referral hospital, which limits generalizability. The findings highlight the high mortality burden and suggest that early ART initiation and monitoring for adverse events are important in managing this co-infection.

PICO

PPOPULATION

390 persons on treatment with a DR-TB/HIV co-infection at Mulago National Referral Hospital, Uganda

IINTERVENTION

Not a specific intervention; study assessed outcomes of standard care and associated factors.

OOUTCOME

Mortality (death during treatment).

STUDY TYPE

cohort

SPECIALTY

infectious disease

SUMMARISED BY

AI pipeline

FIDELITY CHECK

100% · A

ORIGINAL PAPER

PMC10325059

Mortality rate and associated factors among patients co-infected with drug resistant tuberculosis/HIV at Mulago National Referral Hospital, Uganda, a retrospective cohort study

PLOS Global Public Health

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ABSTRACT

Abstract Drug resistant tuberculosis (DR-TB)/HIV co-infection remains a growing threat to public health and threatens global TB and HIV prevention and care programs. HIV is likely to worsen the outcomes of DR-TB and DR-TB is likely to worsen the outcomes of HIV despite the scale up of TB and HIV services and advances in treatment and diagnosis. This study determined the mortality rate and factors associated with mortality among persons on treatment co-infected with drug resistant TB and HIV at Mulago National Referral Hospital. We retrospectively reviewed data of 390 persons on treatment that had a DR-TB/HIV co-infection in Mulago National Referral Hospital from January 2014 to December 2019.Modified poisson regression with robust standard errors was used to determine relationships between the independent variables and the dependent variable (mortality) at bivariate and multivariate analysis. Of the 390 participants enrolled, 201(53.9%) were males with a mean age of 34.6 (±10.6) and 129 (33.2%,95% CI = 28.7–38.1%) died. Antiretroviral therapy(ART) initiation (aIRR 0.74, 95% CI = 0.69–0.79), having a body mass index (BMI)≥18.5Kg/m 2 (aIRR 1.01, 95% CI = 1.03–1.17), having a documented client phone contact (aIRR 0.85, 95% CI = 0.76–0.97), having a mid-upper arm circumference,(MUAC) ≥18.5cm (aIRR 0.90, 95% CI = 0.82–0.99), being on first and second line ART regimen (aIRR 0.83, 95% CI = 0.77–0.89),having a known viral load (aIRR 1.09, 95% CI = 1.00–1.21) and having an adverse event during the course of treatment (aIRR 0.88, 95% CI = 0.83–0.93) were protective against mortality. There was a significantly high mortality rate due to DR-TB/HIV co-infection. These results suggest that initiation of all persons living with HIV/AIDS (PLWHA) with DR-TB on ART and frequent monitoring of adverse drug events highly reduces mortality.

CITATION EXPORT

Joan Rokani Bayowa, Joan N Kalyango, Joseph Baruch Baluku et al.. Mortality rate and associated factors among patients co-infected with drug resistant tuberculosis/HIV at Mulago National Referral Hospital, Uganda, a retrospective cohort study. PLOS Global Public Health. (2023). https://doi.org/10.1371/journal.pgph.0001020

AUTHORS

14 · 4 CENTRES

Joan Rokani Bayowa, Joan N Kalyango, Joseph Baruch Baluku, Richard Katuramu, Emmanuel Ssendikwanawa, Jane Frances Zalwango, Rebecca Akunzirwe, Stella Maris Nanyonga, Judith Ssemasazi Amutuhaire, Ronald Kivumbi Muganga, Adolphus Cherop, Zulma Vanessa Rueda, Zulma Vanessa Rueda, Zulma Vanessa Rueda

1Clinical Epidemiology Unit, College of Health Sciences, Makerere University, Kampala, Uganda
2Mulago National Referral Hospital, Tuberculosis Unit, Kampala, Uganda
3Ministry of Health, Tuberculosis Control Program, Kampala, Uganda
4University of Manitoba College of Medicine: University of Manitoba Max Rady College of Medicine, CANADA