Early mortality during initial treatment of tuberculosis in patients co-infected with HIV at the Yaoundé Central Hospital, Cameroon : an 8-year retrospective cohort study (2006-2013)

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dc.contributor.authorBigna, Jean Joel Ren_ZA
dc.contributor.authorNoubiap, Jean Jacques Nen_ZA
dc.contributor.authorAgbor, Ako Aen_ZA
dc.contributor.authorPlottel, Claudia Sen_ZA
dc.contributor.authorBillong, Serge Clotaireen_ZA
dc.contributor.authorAyong, André Patrick Ren_ZA
dc.contributor.authorKoulla-Shiro, Sinataen_ZA
dc.date.accessioned2015-11-23T12:37:02Z
dc.date.available2015-11-23T12:37:02Z
dc.date.issued2015en_ZA
dc.description.abstractBACKGROUND: Understanding contributors to mortality during the initial phase of tuberculosis (TB) treatment in patients co-infected with HIV would guide targeted interventions to improve survival. The aim of this study was to ascertain the incidence of death during the initial 2 months (new cases) and 3 months (retreatment cases) of TB treatment and to assess correlates of mortality in HIV co-infected patients. METHODS: We conducted a hospital-based retrospective cohort study from January 2006 to December 2013 at Yaoundé Central Hospital, Cameroon. We reviewed medical records to identify co-infected TB/HIV inpatients aged 15 years and older who died during TB treatment. Death was defined as any death occurring during TB treatment, as per World Health Organization recommendations. We collected socio-demographic, clinical and laboratory data. We conducted multivariable logistic binary regression analysis to identify factors associated with death during the intensive phase of TB treatment. Magnitudes of associations were expressed by adjusted odds ratio (a OR ) with 95% confidence interval. A p value < 0.05 was considered statistically significant. RESULTS: The 99 patients enrolled had a mean age of 39.5 (standard deviation 10.9) years and 53% were male. Patients were followed for 276.3 person-months of observation (PMO). Forty nine patients were died during intensive phase of TB treatment. Death incidence during the intensive phase of TB treatment was 32.2 per 100 PMO. Having a non-AIDS comorbidity (a OR 2.47, 95%CI 1.22-5.02, p = 0.012), having extra-pulmonary TB (a OR 1.89, 95%CI 1.05-3.43, p = 0.035), and one year increase in duration of known HIV infection (aOR 1.23, 95%CI 1.004-1.49) were independently associated with death during the intensive phase of TB treatment. CONCLUSIONS: Mortality incidence during intensive phase of TB treatment was high among TB/HIV co-infected patients during TB treatment; and strongly associated with extra pulmonary TB suggesting advanced stage of immunosuppression and non-AIDS comorbidities. Early HIV diagnosis and care and good management of non-comorbidities can reduce this incidence.en_ZA
dc.identifier.apacitationBigna, J. J. R., Noubiap, J. J. N., Agbor, A. A., Plottel, C. S., Billong, S. C., Ayong, A. P. R., & Koulla-Shiro, S. (2015). Early mortality during initial treatment of tuberculosis in patients co-infected with HIV at the Yaoundé Central Hospital, Cameroon : an 8-year retrospective cohort study (2006-2013). <i>PLoS One</i>, http://hdl.handle.net/11427/15353en_ZA
dc.identifier.chicagocitationBigna, Jean Joel R, Jean Jacques N Noubiap, Ako A Agbor, Claudia S Plottel, Serge Clotaire Billong, André Patrick R Ayong, and Sinata Koulla-Shiro "Early mortality during initial treatment of tuberculosis in patients co-infected with HIV at the Yaoundé Central Hospital, Cameroon : an 8-year retrospective cohort study (2006-2013)." <i>PLoS One</i> (2015) http://hdl.handle.net/11427/15353en_ZA
dc.identifier.citationBigna, J. J. R., Noubiap, J. J. N., Agbor, A. A., Plottel, C. S., Billong, S. C., Ayong, A. P. R., & Koulla-Shiro, S. (2015). Early mortality during initial treatment of tuberculosis in patients co-infected with HIV at the Yaoundé Central Hospital, Cameroon : an 8-year retrospective cohort study (2006-2013). PloS one, 10(7), e0132394. doi:10.1371/journal.pone.0132394en_ZA
dc.identifier.ris TY - Journal Article AU - Bigna, Jean Joel R AU - Noubiap, Jean Jacques N AU - Agbor, Ako A AU - Plottel, Claudia S AU - Billong, Serge Clotaire AU - Ayong, André Patrick R AU - Koulla-Shiro, Sinata AB - BACKGROUND: Understanding contributors to mortality during the initial phase of tuberculosis (TB) treatment in patients co-infected with HIV would guide targeted interventions to improve survival. The aim of this study was to ascertain the incidence of death during the initial 2 months (new cases) and 3 months (retreatment cases) of TB treatment and to assess correlates of mortality in HIV co-infected patients. METHODS: We conducted a hospital-based retrospective cohort study from January 2006 to December 2013 at Yaoundé Central Hospital, Cameroon. We reviewed medical records to identify co-infected TB/HIV inpatients aged 15 years and older who died during TB treatment. Death was defined as any death occurring during TB treatment, as per World Health Organization recommendations. We collected socio-demographic, clinical and laboratory data. We conducted multivariable logistic binary regression analysis to identify factors associated with death during the intensive phase of TB treatment. Magnitudes of associations were expressed by adjusted odds ratio (a OR ) with 95% confidence interval. A p value < 0.05 was considered statistically significant. RESULTS: The 99 patients enrolled had a mean age of 39.5 (standard deviation 10.9) years and 53% were male. Patients were followed for 276.3 person-months of observation (PMO). Forty nine patients were died during intensive phase of TB treatment. Death incidence during the intensive phase of TB treatment was 32.2 per 100 PMO. Having a non-AIDS comorbidity (a OR 2.47, 95%CI 1.22-5.02, p = 0.012), having extra-pulmonary TB (a OR 1.89, 95%CI 1.05-3.43, p = 0.035), and one year increase in duration of known HIV infection (aOR 1.23, 95%CI 1.004-1.49) were independently associated with death during the intensive phase of TB treatment. CONCLUSIONS: Mortality incidence during intensive phase of TB treatment was high among TB/HIV co-infected patients during TB treatment; and strongly associated with extra pulmonary TB suggesting advanced stage of immunosuppression and non-AIDS comorbidities. Early HIV diagnosis and care and good management of non-comorbidities can reduce this incidence. DA - 2015 DB - OpenUCT DO - 10.1371/journal.pone.0132394 DP - University of Cape Town J1 - PLoS One LK - https://open.uct.ac.za PB - University of Cape Town PY - 2015 T1 - Early mortality during initial treatment of tuberculosis in patients co-infected with HIV at the Yaoundé Central Hospital, Cameroon : an 8-year retrospective cohort study (2006-2013) TI - Early mortality during initial treatment of tuberculosis in patients co-infected with HIV at the Yaoundé Central Hospital, Cameroon : an 8-year retrospective cohort study (2006-2013) UR - http://hdl.handle.net/11427/15353 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/15353
dc.identifier.urihttp://dx.doi.org/10.1371/journal.pone.0132394
dc.identifier.vancouvercitationBigna JJR, Noubiap JJN, Agbor AA, Plottel CS, Billong SC, Ayong APR, et al. Early mortality during initial treatment of tuberculosis in patients co-infected with HIV at the Yaoundé Central Hospital, Cameroon : an 8-year retrospective cohort study (2006-2013). PLoS One. 2015; http://hdl.handle.net/11427/15353.en_ZA
dc.language.isoengen_ZA
dc.publisherPublic Library of Scienceen_ZA
dc.publisher.departmentDepartment of Medicineen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rightsThis is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.en_ZA
dc.rights.holder© 2015 Bigna et alen_ZA
dc.rights.urihttp://creativecommons.org/licenses/by/4.0en_ZA
dc.sourcePLoS Oneen_ZA
dc.source.urihttp://journals.plos.org/plosoneen_ZA
dc.subject.otherTuberculosisen_ZA
dc.subject.otherHIVen_ZA
dc.subject.otherDeath ratesen_ZA
dc.subject.otherHIV infectionsen_ZA
dc.subject.otherTuberculosis diagnosis and managementen_ZA
dc.subject.otherAntiretroviral therapyen_ZA
dc.subject.otherHIV diagnosis and managementen_ZA
dc.subject.otherBlood countsen_ZA
dc.titleEarly mortality during initial treatment of tuberculosis in patients co-infected with HIV at the Yaoundé Central Hospital, Cameroon : an 8-year retrospective cohort study (2006-2013)en_ZA
dc.typeJournal Articleen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
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