Tuberculosis Cases and Treatment Outcomes in a HIV Cohort on an HIV program in Cambodia

Author: Prahors Ung

Abstract

There is very limited documented information on the occurrence of TB and outcome of treatment among TB/HIV co-infected adults patients enrolled within HIV programs in resource-limited settings. A detailed analysis in the Cambodian setting will bring better understanding in this context where little other data exists.

A retrospective cohort study of routine data from the Chronic Disease Clinic in Donkeo Referral Hospital of Takeo province which was carried out by MSF B from 2003 to 2008. It comprised 3320 HIV adults’ patients receiving free care for a 66 month period.

The outcomes of TB treatment in this HIV cohort were assessed. In total there were 1114 TB cases detected out of 3320 HIV positive patients (30%). Out of these, 239 cases (21.45%) were smear positive pulmonary tuberculosis, and of which 338 (30.34%) cases were smear negative pulmonary tuberculosis. 93.8% were new cases. The most predominant type of Extra-Pulmonary Tuberculosis (EPTB) among HIV positive patients was the infection of the lymph nodes which was 252 cases ( 54.9%), followed by 123 cases of digestive tract EPTB (26.8%). Among 1114 TB cases, 59.7% were treatment completed 7.2% were cured and 15.8% died. There was a high death rate among HIV/TB co-infected new Positive Sputum Smear Pulmonary Tuberculosis (M+) of 14% whilst the cure rate was 34%; the defaulter rate which was 9.3%.