Missed opportunities for accessing HIV care among Tshwane tuberculosis patients under different models of care

Loading...
Thumbnail Image

Authors

Louwagie, Goedele M.C.
Girdler-Brown, B.V. (Brendan)
Odendaal, Rhode
Rossouw, Theresa M.
Johnson, S.
Van der Walt, Marthie S.

Journal Title

Journal ISSN

Volume Title

Publisher

International Union Against Tuberculosis and Lung Disease

Abstract

BACKGROUND: This study aimed to compare access to HIV care for tuberculosis patients in settings with Antiretroviral Treatment (ART) and tuberculosis care under one roof (“semi-integrated sites”) and settings with geographically separately rendered care, in Tshwane, South Africa. METHODS: Historical cohort study of patients registered with tuberculosis at 46 TB treatment points, with follow-up until the end of TB treatment. ART initiation for HIV-positive TB patients was established through linkage of TB register patient identifiers to the electronic ART register. Data analysis entailed univariate and multivariate competing risk analysis. RESULTS: Records of 636 and 1297 patients for semi-integrated and separate facilities respectively were reviewed. Co-trimoxazole prophylactic therapy and CD4 count recording were lower in semi-integrated than separate facilities, but the reverse was true for referral to HIV-related care. A higher percentage of patients started ART in semi-integrated than in separate facilities (70.5% vs. 44.6%, P < 0.001). In competing risk analysis (with death and LTFU as competing risks), attending a semi-integrated facility (SHR 2.49, 95%CI 1.06-5.88) and TB case load > 401 (SHR 1.45, 95%CI 1.04-2.03) were associated with increased ART initiation. CONCLUSIONS: ART and TB treatment under one roof appears to facilitate ART initiation for HIV-positive TB patients.

Description

Keywords

Tuberculosis (TB), Antiretroviral treatment (ART), Integration

Sustainable Development Goals

Citation

Louwagie, G, Girdler-Brown, B, Odendaal, R, Rossouw, T, Johnson, S & Van der Walt, M 2012, 'Missed opportunities for accessing HIV care among Tshwane tuberculosis patients under different models of care', International Journal of Tuberculosis and Lung Disease, vol. 16, no. 8, pp. 1052-1058.