Abstrait

Treatment outcome of tuberculosis patients with HIV under Directly Observed Treatment Short Course (DOTS) in Lubumbashi (D.R. Congo).

Christian Kakisingi, Olivier Mukuku, Patricia Kajimb, Michel Manika, Tshikuluila Beya, Christian Kibulungu, Patrick Mutombo, Dieudonné Ngwej, Hippolyte Situakibanza, Claude Mulumba1

Introduction: Tuberculosis (TB) is one of the major public health and socio-economic issues in the 21st century globally. Assessment of TB treatment outcomes, and monitoring and evaluation of its risk factors in Directly Observed Treatment Short Course (DOTS) are among the major indicators of the performance of a national TB control program. Thus, the current study was carried to evaluate outcomes and to determine factors affecting outcome in TB patients with HIV. Materials and Methods: Between January 2010 to December 2014 all tuberculosis patients enrolled in DOTS clinic of the Lubumbashi’s Health Zone were collected retrospectively from the TB registration book. We compared the data for TB patients of HIV positive and negative subjects. Medical records of the patients were reviewed for age, gender, type, category and treatment outcome. Results: A total of 3558 tuberculosis patients were registered in the Lubumbashi’s Health Zone between January 2010-December 2014. Of these, 2063 (57.98%) were male, 1502 (42.02%) were smear positive pulmonary TB (PTB+), 125 (3.51%) were smear negative pulmonary TB (PTB-) and 1931(54.27%) were extra pulmonary TB (EPTB) patients. We evaluated 1653 registered patients (HIV screening rate: 46.46%), of these, 256(15.49%) were HIV positive patients. The overall treatment success rate was 83.3% and failure rate 16.7% of tuberculosis patients with and without HIV. Tuberculosis type, age, outcome and category of TB patients were significantly associated with TB-HIV co-infection. PTB+ patients and others category of patients were significantly adverse for outcome of patients with TB-HIV co-infection. Conclusion: It appears that DOTS have improved treatment success in the Lubumbashi’s Health Zone for five years. However, this study shows clearly that TB-HIV coinfection have a negatively impacts on TB treatment outcome and TB screening should be encouraged in TB patients.