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Free Content Outcomes of tuberculosis patients who start antiretroviral therapy under routine programme conditions in Malawi

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SETTING: Public sector facilities in Malawi providing antiretroviral therapy (ART) to human immunodeficiency virus (HIV) positive patients, including those with tuberculosis (TB).

OBJECTIVES: To compare 6-month and 12-month cohort treatment outcomes of HIV-positive TB patients and HIV-positive non-TB patients treated with ART.

DESIGN: Retrospective data collection using ART patient master cards and ART patient registers.

RESULTS: Between July and September 2005, 7905 patients started ART, 6967 with a non-TB diagnosis and 938 with a diagnosis of active TB. 6-month cohort outcomes of non-TB and TB patients censored on 31 March 2006 showed significantly more TB patients alive and on ART (77%) compared with non-TB patients (71%) (P < 0.001). Between January and March 2005, 4580 patients started ART, 4179 with a non-TB diagnosis and 401 with a diagnosis of active TB. 12-month cohort outcomes of non-TB and TB patients censored on 31 March 2006 showed significantly more TB patients alive and on ART (74%) compared with non-TB patients (66%) (P < 0.001). Other outcomes of default and transfer out were also significantly less frequent in TB compared with non-TB patients.

CONCLUSION: HIV-positive TB patients on ART in Malawi have generally good treatment outcomes, and more patients need to access this HIV treatment.
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Keywords: Malawi; antiretroviral therapy; treatment outcomes; tuberculosis

Document Type: Regular Paper

Affiliations: 1: Clinical HIV Unit, Ministry of Health, Lilongwe, Malawi 2: Clinical HIV Unit, Ministry of Health, Lilongwe, Malawi; Family Health International, Malawi Country Office, Lilongwe, Malawi; and London School of Hygiene and Tropical Medicine, London, UK 3: Taiwan Medical Mission, Mzuzu Central Hospital, Mzuzu, Malawi 4: US Centres for Disease Control and Prevention, Malawi Office, Lilongwe, Malawi 5: Lighthouse Clinic, Lilongwe, Malawi 6: M├ędecins sans Frontieres, Brussels, Belgium; and Thyolo District Hospital, Thyolo, Malawi 7: Ministry of Health, Lilongwe, Malawi; and Management Sciences for Health, Lilongwe, Malawi

Publication date: April 1, 2007

More about this publication?
  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on lung health world-wide.

    To share scientific research of immediate concern as rapidly as possible, The Union is fast-tracking the publication of certain articles from the IJTLD and publishing them on The Union website, prior to their publication in the Journal. Read fast-track articles.

    Certain IJTLD articles are also selected for translation into French, Spanish, Chinese or Russian. These are available on the Union website.

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