Assessing the accessibility of HIV care packages among tuberculosis patients in the Northwest Region, Cameroon

Njozing, Nwarbébé Barnabas; Miguel, San Sebastian; Tih, Pius Muffih; Hurtig, Anna-Karin
January 2010
BMC Public Health;2010, Vol. 10 Issue 1, p129
Academic Journal
Background: Tuberculosis (TB) and human immunodeficiency virus (HIV) co-infection is a major source of morbidity and mortality globally. The World Health Organization (WHO) has recommended that HIV counselling and testing be offered routinely to TB patients in order to increase access to HIV care packages. We assessed the uptake of provider-initiated testing and counselling (PITC), antiretroviral (ART) and co-trimoxazole preventive therapies (CPT) among TB patients in the Northwest Region, Cameroon. Methods: A retrospective cohort study using TB registers in 4 TB/HIV treatment centres (1 public and 3 faithbased) for patients diagnosed with TB between January 2006 and December 2007 to identify predictors of the outcomes; HIV testing/serostatus, ART and CPT enrolment and factors that influenced their enrolment between public and faith-based hospitals. Results: A total of 2270 TB patients were registered and offered pre-HIV test counselling; 2150 (94.7%) accepted the offer of a test. The rate of acceptance was significantly higher among patients in the public hospital compared to those in the faith-based hospitals (crude OR 1.97; 95% CI 1.33 - 2.92) and (adjusted OR 1.92; 95% CI 1.24 - 2.97). HIV prevalence was 68.5% (1473/2150). Independent predictors of HIV-seropositivity emerged as: females, age groups 15-29, 30-44 and 45-59 years, rural residence, previously treated TB and smear-negative pulmonary TB. ART uptake was 50.3% (614/1220) with 17.2% (253/1473) of missing records. Independent predictors of ART uptake were: previously treated TB and extra pulmonary TB. Finally, CPT uptake was 47.0% (524/1114) with 24% (590/1114) of missing records. Independent predictors of CPT uptake were: faith-based hospitals and female sex. Conclusion: PITC services are apparently well integrated into the TB programme as demonstrated by the high testing rate. The main challenges include improving access to ART and CPT among TB patients and proper reporting and monitoring of programme activities.


Related Articles

  • HIV Testing and Treatment Among Tuberculosis Patients -- Kenya, 2006-2009. Sitienei, J.; Kipruto, H.; Nganga, L.; Ackers, M.; Odhiambo, J.; Laserson, K.; Nakashima, A. K.; Modi, S. // MMWR: Morbidity & Mortality Weekly Report;11/26/2010, Vol. 59 Issue 46, p1514 

    The article discusses a report on HIV data from Kenya's tuberculosis (TB) surveillance system from 2006 to 2009. The Kenya Division of Leprosy, Tuberculosis and Lung Disease (DLTLD) added HIV testing and treatment to its TB surveillance program at the recommendation of the World Health...

  • Management of Tuberculosis in Children and New Treatment Options. Marais, B. J.; Schaaf, H. S.; Donald, P. R. // Infectious Disorders - Drug Targets;Apr2011, Vol. 11 Issue 2, p144 

    No abstract available.

  • First WHO guidance on antiretrovirals in HIV prophylaxis.  // PharmacoEconomics & Outcomes News;8/4/2012, Issue 659, p2 

    The article reports on the publication of the first guideline by the World Health Organization in August 2012 on the use of antiretrovirals in pre-exposure prophylaxis for the management of people who are at risk of HIV infection.

  • What Is the Optimal First Line Antiretroviral Therapy in Resource-Limited Settings? Kenyon, Chris; Colebunders, Robert // PLoS Medicine;Aug2012, Vol. 9 Issue 8, p1 

    The authors discuss aspects the role of optimal first line antiretroviral therapy (ART) in resource-limited settings (RLS). They mention that its selection needs cautious balancing which involves effective regimens and costs. They note that such therapy can improve life expectancy as well as...

  • HIV Treatment-as-Prevention Research at a Crossroads. Bärnighausen, Till; Eyal, Nir; Wikler, Daniel // PLoS Medicine;Jun2014, Vol. 11 Issue 6, p1 

    : In light of changing WHO guidelines for HIV treatment, Till Bärnighausen and colleagues consider how large-scale HIV treatment-as-prevention trials can be adapted so that they can remain viable. Please see later in the article for the Editors' Summary

  • Will Adoption of the 2010 WHO ART Guidelines for HIVInfected TB Patients Increase the Demand for ART Services in India? Kumar, Ajay M. V.; Gupta, Devesh; Rewari, B. B.; Bachani, Damodar; Mohammed, Suresh; Sharma, Vartika; Lal, Kumaraswamy; Reddy, H. R. Raveendra; Naik, Balaji; Prasad, Rita; Yaqoob, Mohammed; Deepak, K. G.; Shastri, Suresh; Satyanarayana, Srinath; Harries, Anthony David; Chauhan, Lakhbir Singh; Dewan, Puneet // PLoS ONE;2011, Vol. 6 Issue 9, p1 

    Background: In 2010, WHO expanded previously-recommended indications for anti-retroviral treatment to include all HIVinfected TB patients irrespective of CD4 count. India, however, still limits ART to those TB patients with CD4 counts <350/ mm3 or with extrapulmonary TB manifestations. We sought...

  • Initial Response to Protease-Inhibitor-Based Antiretroviral Therapy among Children Less than 2 Years of Age in South Africa: Effect of Cotreatment for Tuberculosis. Reitz, Cordula; Coovadia, Ashraf; Ko, Stephen; Meyers, Tammy; Strehlau, Renate; Sherman, Gayle; Kuhn, Louise; Abrams, Elaine J. // Journal of Infectious Diseases;4/15/2010, Vol. 201 Issue 8, p1121 

    Background. South African guidelines recommend protease-inhibitor-based antiretroviral therapy (ART) with lopinavir-ritonavir for human immunodeficiency virus (HIV)-infected children <36 months of age.We investigated factors associated with viral suppression and mortality among young children...

  • Role of the US President's Emergency Plan for AIDS Relief in Responding to Tuberculosis and HIV Coinfection. Coggin, William L.; Ryan, Caroline A.; Holmes, Charles B. // Clinical Infectious Diseases;May2010 Supplement 3, Vol. 50, pS255 

    The intersection of tuberculosis (TB) and human immunodeficiency virus (HIV) infection has eroded gains made in TB control, because previously well-functioning national TB programs have been overwhelmed by the dual challenges posed by TB and HIV coinfection. The US President's Emergency Plan for...

  • Monitoring of antiretroviral safety and efficacy.  // WHO Drug Information;2004, Vol. 18 Issue 3, p228 

    The article reports that many countries in Africa are introducing combinations of antiretrovirals as part of the World health Organization's (WHO) 3 by 5 Strategy to provide antiretroviral treatment to 3 million people by 2005. A workshop has been organized by WHO in South Africa from September...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics