Risk Factors for TB/HIV Coinfection and Consequences for Patient Outcomes: Evidence from 241 Clinics in the Democratic Republic of Congo

Gulzar Hussain Shah, Raimi Ewetola, Gina Etheredge, Lievain Maluantesa, Kristie Waterfield, Elodie Engetele and Apolinaire Kilundu
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Gulzar Hussain Shah: Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro/Savannah, GA 30460, USA
Raimi Ewetola: Division of Global HIV and Tuberculosis, CDC, Atlanta, GA 30333, USA
Gina Etheredge: FHI 360, Washington, DC 20009, USA
Lievain Maluantesa: FHI 360, Kinshasa 1015, Democratic Republic of the Congo
Kristie Waterfield: Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro/Savannah, GA 30460, USA
Elodie Engetele: FHI 360, Kinshasa 1015, Democratic Republic of the Congo
Apolinaire Kilundu: National AIDS Control Program (PNLS), Democratic Republic of the Congo

IJERPH, 2021, vol. 18, issue 10, 1-13

Abstract: (1) Background: In resource-limited countries, patients with tuberculosis (TB)/HIV coinfection commonly face economic, sociocultural, and behavioral barriers to effective treatment. These barriers manifest from low treatment literacy, poverty, gender inequality, malnutrition, societal stigmas regarding HIV, and an absence of available care. It is critical for intervention programs to understand and assist in overcoming these barriers and any additional risks encountered by patients with TB/HIV coinfection. This study analyzes variation in TB/HIV coinfection and risks of negative outcomes among patients with TB/HIV coinfection compared to those without coinfection. (2) Methods: This quantitative study used data from 49,460 patients receiving ART from 241 HIV/AIDS clinics in Haut-Katanga and Kinshasa, two provinces in the Democratic Republic of Congo. Chi-square and logistic regression analysis were performed. (3) Results: Significantly higher proportions of patients with TB/HIV coinfection were men (4.5%; women, 3.3%), were new patients (3.7%; transferred-in, 1.6%), resided in the Kinshasa province (4.0%; Haut-Katanga, 2.7%), and were in an urban health zone (3.9%) or semi-rural health zone (3.1%; rural, 1.2%). Logistic regression analysis showed that after controlling for demographic and clinical variables, TB/HIV coinfection increased the risk of death (adjusted odds ratio (AOR), 2.26 (95% confidence interval (CI): 1.94–2.64)) and LTFU (AOR, 2.06 (95% CI: 1.82–2.34)). TB/HIV coinfection decreased the odds of viral load suppression (AOR, 0.58 (95% CI: 0.46–0.74)). (4) Conclusions: TB/HIV coinfection raises the risk of negative outcomes such as death, LTFU, and lack of viral load suppression. Our findings can help HIV clinics in Democratic Republic of Congo and other African countries to customize their interventions to improve HIV care and reduce care disparities among patients.

Keywords: TB/HIV coinfection; Democratic Republic of Congo; HIV loss to follow-up; viral load suppression; death of HIV/AIDS patient (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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