title: Decline in adverse outcomes and death in tuberculosis patients in Malawi: association with HIV interventions.
abstract: Between 2000 and 2012, the annual numbers of patients treated for tuberculosis (TB) in Malawi declined by 28%, from 28 234 to 20 463. During this time, the proportion of TB patients tested for the human immunodeficiency virus (HIV) increased from 6% to 87%. Most HIV-infected patients received cotrimoxazole preventive therapy, and the proportion receiving antiretroviral therapy increased to 88%. Between 2000 and 2008 there was a significant decline in all adverse outcomes (from 31% to 14%), and particularly in deaths (from 23% to 10%) and loss to follow-up (from 5.2% to 1.9%, P < 0.001). After 2008, there was no decrease in any adverse outcome. Ways to further reduce TB-associated mortality are discussed.
authors.affiliation: National Tuberculosis Control Programme, Community Health Science Unit, Lilongwe, Malawi.
authors.forename: H
authors.initials: H
authors.lastname: Kanyerere
authors.affiliation: Department of HIV and AIDS, Ministry of Health, Lilongwe, Malawi.
authors.forename: A
authors.initials: A
authors.lastname: Mganga
authors.affiliation: International Union Against Tuberculosis and Lung Disease, Paris, France ; London School of Hygiene and Tropical Medicine, London, UK.
authors.forename: A D
authors.initials: AD
authors.lastname: Harries
authors.affiliation: Médecins Sans Frontières, Medical Department, Operational Centre Brussels, MSF-Luxembourg, Luxembourg.
authors.forename: K
authors.initials: K
authors.lastname: Tayler-Smith
authors.affiliation: Médecins Sans Frontières, Medical Department, Operational Centre Brussels, MSF-Luxembourg, Luxembourg.
authors.forename: R
authors.initials: R
authors.lastname: Zachariah
authors.affiliation: Department of HIV and AIDS, Ministry of Health, Lilongwe, Malawi ; International Training and Education Center for Health Malawi, University of Washington, Seattle, Washington, USA.
authors.forename: A
authors.initials: A
authors.lastname: Jahn
authors.affiliation: Department of HIV and AIDS, Ministry of Health, Lilongwe, Malawi.
authors.forename: F M
authors.initials: FM
authors.lastname: Chimbwandira
authors.affiliation: National Tuberculosis Control Programme, Community Health Science Unit, Lilongwe, Malawi.
authors.forename: J
authors.initials: J
authors.lastname: Mpunga
keywords: HIV/AIDS; Malawi; antiretroviral therapy; death; tuberculosis outcomes