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Home >> Publications >> Characteristics of adults and children diagnosed with tuberculosis in Lilongwe, Malawi: findings from an integrated HIV/TB clinic.

Publication

Author(s):

Feldacker C, Tweya H, Keiser O, Weigel R, Kalulu M, Fenner L, Egger M, Manda E, Mwafilaso JB, Kamba C, Phiri S.

Pub Title:

Characteristics of adults and children diagnosed with tuberculosis in Lilongwe, Malawi: findings from an integrated HIV/TB clinic.

Pub Date:

Sep 30 2012

Pub Region(s):

Southern Africa

Journal Issue:

9

Page Number:
1108-16

Journal:

Title: 
Tropical Medicine and International Health
Link: 
http://onlinelibrary.wiley.com/doi/10.1111/j.1365-3156.2012.03041.x/abstract

PubMed: 22808948
Pub PDF: PDF icon 22808948.pdf

Abstract
OBJECTIVES
: To describe initial registration characteristics of adult and paediatric TB patients at a large, public, integrated TB and HIV clinic in Lilongwe, Malawi, between January 2008 and December 2010.

METHODS: Routine data on patient with TB category and TB type, stratified by HIV and ART status, were used to explore differences in proportions among TB only, TB/HIV co-infected patients not on ART and TB/HIV co-infected patients on ART using chi-square tests. Trends over time illustrate strengths and weaknesses of integrated service provision.

RESULTS: Among 10 143 adults, HIV ascertainment and ART uptake were high and increased over time. The proportion of relapse was highest among those on ART (5%). The proportion of smear-positive pulmonary TB (PTB) was highest among HIV-negative patients with TB (34.9%); extra-pulmonary TB (EPTB) was lowest among TB only (16.2%). Among 338 children <15 years, EPTB and smear-positive PTB were more common among TB-only patients. Time trends showed significant increases in the proportion of adults with smear-positive PTB and the proportion of adults already on ART before starting TB treatment. However, some co-infected patients still delay ART initiation.

CONCLUSIONS: HIV ascertainment and ART uptake among co-infected patients are successful and improving over time. However, delays in ART initiation indicate some weakness linking TB/HIV patients into ART during TB follow-up care. Improved TB diagnostics and screening efforts, especially for paediatric patients, may help improve quality care for co-infected patients. These results may aid efforts to prioritise TB and HIV prevention, education and treatment campaigns for specific populations.

© 2012 Blackwell Publishing Ltd.

PMID: 22808948 [PubMed - indexed for MEDLINE]

PMCID: PMC3767918

 
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Citation:

Feldacker C, Tweya H, Keiser O, Weigel R, Kalulu M, Fenner L, Egger M, Manda E, Mwafilaso JB, Kamba C, Phiri S. Characteristics of adults and children diagnosed with tuberculosis in Lilongwe, Malawi: findings from an integrated HIV/TB clinic. Trop Med Int Health. 2012 Sep;17(9):1108-16. doi: 10.1111/j.1365-3156.2012.03041.x. Epub 2012 Jul 19. PubMed PMID: 22808948; PubMed Central PMCID: PMC3767918.