Between 2000 and 2012, the annual numbers of patients treated for tuberculosis (TB) in Malawi declined by 28%, from 28,234 to 20,463. During this time, the proportion of TB patients tested for the human immunodeficiency virus (HIV) increased from 6% to 87%. Most HIV-infected patients received cotrimoxazole preventive therapy, and the proportion receiving antiretroviral therapy increased to 88%. Between 2000 and 2008 there was a significant decline in all adverse outcomes (from 31% to 14%), and particularly in deaths (from 23% to 10%) and loss to follow-up (from 5.2% to 1.9%, P < 0.001). After 2008, there was no decrease in any adverse outcome. Ways to further reduce TB-associated mortality are discussed.
This research was supported by the UK Department for International Development’s Operational Research Capacity Building Programme led by the International Union Against TB and Lung Disease (The Union)
H. Kanyerere, A. Mganga, A. D. Harries, K. Tayler-Smith, R. Zachariah, A. Jahn, F. M. Chimbwandira, J. Mpunga (2015) Decline in adverse outcomes and death in tuberculosis patients in Malawi: association with HIV interventions. Public Health Action; 5(2):116-8. doi: 10.5588/pha.14.0109.
Decline in adverse outcomes and death in tuberculosis patients in Malawi: association with HIV interventions