dc.contributor.advisor |
Louwagie, Goedele M.C. |
|
dc.contributor.coadvisor |
Marinda, E. |
|
dc.contributor.postgraduate |
Alakaye, Odunayo Johnson |
|
dc.date.accessioned |
2019-06-02T11:39:59Z |
|
dc.date.available |
2019-06-02T11:39:59Z |
|
dc.date.created |
2019/04/26 |
|
dc.date.issued |
2018 |
|
dc.description |
Dissertation (MSc)--University of Pretoria, 2018. |
|
dc.description.abstract |
Background: Multi-Drug resistant tuberculosis (MDR-TB, resistance to at least Isoniazid and rifampicin) is a disease of public health importance, accounting for an estimated 490,000 new cases globally in 2016. Historically, cure rates in MDR-TB/HIV co-infected patients were lower than in HIV negative patients, partly due to high morbidity and mortality associated with retro-viral disease.
Lesotho has one of the highest levels of tuberculosis and probably multidrug-resistant TB in the world. However, efforts to control this disease including the introduction of the World Health Organization (WHO)-recommended DOTS-Plus and recently endTB strategies for multi-drug resistant TB contributed significantly to the decline of the disease.
Aim: This study evaluated the association between HIV and time to sputum culture conversion in MDR-TB patients who were on the MDR-TB regimen and Antiretroviral treatment (if HIV positive), between January 2011 and December 2016.
Method: The study used a retrospective cohort study design of consecutive patients who were initiated on MDR-TB regimen from January 2011 to June 2016 in Lesotho. All patients were followed up until death, loss to follow-up, sputum conversion or censored at the end of December 2016, whichever came first.
Results: A total of 346 patients with confirmed MDR-TB records were included in the study. Of these, 58.02% (n=199) were male, a third of the patients were married (n= 122 [35.67%]) and about four fifths (n=277 [81.15%]) were HIV positive. The HIV positive patients achieved sputum culture clearance at a median of 54.22 (IQR 22-117) days, while the HIV negative patients achieved conversion at 60.84 (IQR 24-129) days. There was no statistically significant difference in the sputum culture conversion rates by HIV status (AHR: 1.11, CI: 0.82-1.50, p-value: 0.486). Residing in rural area (AHR: 1.60 CI: 1.20-2.14, P-value: 0.001) and good adherence (AHR: 15.84 CI: 2.21-113.60, P-value: 0.006) independently predicted higher sputum culture clearance rates.
Conclusion: HIV-status does not affect sputum culture conversion in MDR-TB patients on ART in Lesotho. |
|
dc.description.availability |
Unrestricted |
|
dc.description.degree |
MSc |
|
dc.description.department |
School of Health Systems and Public Health (SHSPH) |
|
dc.identifier.citation |
Alakaye, OJ 2018, Time to sputum culture conversion of Multidrug-Resistant tuberculosis in HIV positive versus HIV negative patients in Lesotho, MSc Dissertation, University of Pretoria, Pretoria, viewed yymmdd <http://hdl.handle.net/2263/70068> |
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dc.identifier.other |
A2019 |
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dc.identifier.uri |
http://hdl.handle.net/2263/70068 |
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dc.language.iso |
en |
|
dc.publisher |
University of Pretoria |
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dc.rights |
© 2019 University of Pretoria. All rights reserved. The copyright in this work vests in the University of Pretoria. No part of this work may be reproduced or transmitted in any form or by any means, without the prior written permission of the University of Pretoria. |
|
dc.subject |
UCTD |
|
dc.title |
Time to sputum culture conversion of Multidrug-Resistant tuberculosis in HIV positive versus HIV negative patients in Lesotho |
|
dc.type |
Dissertation |
|