title: Treatment outcome of human immunodeficiency virus and tuberculosis co-infected patients in public hospitals of eastern and southern zone of Tigray region, Ethiopia.
abstract: BACKGROUND
  Tuberculosis is a leading cause of death among people living with human immunodeficiency virus. In sub-Saharan Africa, tuberculosis accounts for more than 78% of all deaths among people with human immunodeficiency virus.
  
  
  OBJECTIVE
  To assess tuberculosis treatment outcome and the associated factors in adult tuberculosis/human immunodeficiency virus co-infected patients in four public hospitals of eastern and southern zone of Tigray region, Ethiopia.
  
  
  METHODS
  Institution based cross-sectional study design was used to examine secondary data from tuberculosis/human immunodeficiency virus co-infected patients attending four public hospitals of eastern and southern zone of Tigray, from January 2009 to August 2011. Systematic random sampling technique was used to select individual patient cards from the respective hospitals. Univariate analysis and multivariate logistic regression modeling was used to assess the impact of each variable in predicting treatment outcome.
  
  
  RESULTS
  Out of 342 patients included, 199 (58.2%) patients completed treatment, 43 (12.6%) patients were cured, 88 (25.7%) died, 7 (2%) defaulted, and 5 (1.5%) patients failed treatment. Treatment success rate was around 71%. In the multivariate logistic regression analysis the factors that were strongly associated with unfavorable tuberculosis treatment outcomes were WHO stage IV (AOR=3.2, CI=1.58-6.82, p-value=0.001), age greater than 45 years (AOR=6.08, CI=2.28-16.23) and baseline CD4 count less than 200cells/μL (AOR=6.19, CI=2.28-16.89, p-value=0.001).
  
  
  CONCLUSIONS
  The rate of treatment success in this study was lower than the rate newly recommended by WHO. Therefore, efforts should be undertaken to improve treatment success rates of both diseases.
authors.affiliation: School of Public Health, Hawassa University, Hawassa, Ethiopia. Electronic address: belaynehdinage@gmail.com.
authors.forename: Mehretu
authors.initials: M
authors.lastname: Belayneh
authors.affiliation: Lemlem Karl Public Hospital, Tigrai, Ethiopia.
authors.forename: Kalayta
authors.initials: K
authors.lastname: Giday
authors.affiliation: Federal Ministry of Health, Addis Ababa, Ethiopia.
authors.forename: Hailemariam
authors.initials: H
authors.lastname: Lemma
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D000995:Antitubercular Agents / Q000627:therapeutic use*; D018791:CD4 Lymphocyte Count; D060085:Coinfection / Q000188:drug therapy* / Q000401:mortality; D003430:Cross-Sectional Studies; D005002:Ethiopia; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000401:mortality*; D006779:Hospitals, Public; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy* / Q000401:mortality; D055815:Young Adult
chemical_list: D019380:Anti-HIV Agents; D000995:Antitubercular Agents
keywords: Ethiopia; TB/HIV co-infected; Tigray; Treatment outcome