Abstract
BackgroundTB and HIV are public health problems, which have a synergistic effect to each other. Despite the decreasing burden of these two diseases they still make a significant contribution to mortality. Tanzania is among the 30 high TB and HIV burden countries.MethodsRoutine data over 6 years from people living with HIV (PLHIV) attending health facilities in three regions of Northern Tanzania were analyzed, showing mortality trends from 2012 to 2017 for HIV and HIV/TB subpopulations. Poisson regression with frailty model adjusting for clustering at health facility level was used to analyze the data to determine mortality rate ratios (RR) and 95% confidence intervals (95%CI).ResultsAmong all PLHIV the overall mortality rate was 28.4 (95% CI 27.6–29.2) deaths per 1000 person-years. For PLHIV with no evidence of TB the mortality rates was 26.2 (95% CI 25.4–27.0) per 1000 person-years, and for those with HIV/TB co-infection 57.8 (95% CI 55.6–62.3) per 1000 person-years. After adjusting for age, sex, residence, WHO stage, and bodyweight, PLHIV with TB co-infection had 40% higher mortality than those without TB (RR 1.4; 95% CI 1.24–1.67).ConclusionsOver the 6-year period mortality rates for HIV/TB patients were consistently higher than for PLHIV who have no TB. More efforts should be directed into improving nutritional status among HIV patients, as it has destructive interaction with TB for mortality. This will improve patients’ body weight and CD4 counts which are protective against mortality. Among PLHIV attention should be given to those who are in WHO HIV stage 3 or 4 and having TB co-infection.
Highlights
TB and Human immunodeficiency virus (HIV) are public health problems, which have a synergistic effect to each other
The mortality rate was 26.2 per 1000 person-years among people living with HIV (PLHIV) who had no TB, and 57.8 per 1000 person-years among those with HIV/TB co-infection (Table 1)
The highest mortality rates were among patients who were ambulatory
Summary
TB and HIV are public health problems, which have a synergistic effect to each other. HIV on the other hand lowers the immunity against TB leading to increased active TB infection, re-infection, or reactivation. It increases the risk of TB progression from latent TB to Mollel et al Tropical Medicine and Health (2020) 48:26 activities, with increased use of Isoniazid Preventive Therapy (IPT) among PLHIV, have contributed to reduced mortality rates [6, 19, 28, 39]. HIV/TB co-infected patients have 1.8 times higher risk of mortality compared to those who are HIVinfected TB-free patients [4]. The odds of mortality are 3.5 times higher when the patients have HIV/Drug Resistant Tuberculosis co-infection [23]. Tanzania is among the 30 high TB and HIV burden countries
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
