High prevalence/incidence of TB and poor outcomes of TB treatment among people living with HIV/AIDS (PLWHA) in Phnom Penh, Cambodia
Background: TB screening clinic for PLWHA at National Center for TB Control (CENAT) in Phnom Penh, the capital city of Cambodia, was started in November 2001.
Methods: The target of the screening was initially PLWHA under a home-based care program and expanded to HIV positive clients of exiting Voluntary Counseling and Testing centers (VCT) since March 2003. The screening included chest radiography, physical examinations, and symptom questionnaire. Detected TB cases were treated with 8 months chemotherapy of 2HRZE+6HE by routine DOTS programs.
Results: Total 1,912 PLWHA completed the screening by the end of 2003. TB was found in 361 (18.9%) PLWHA at their first screening. Types of TB were 99 (27.4%) smear positive pulmonary TB include 1 relapse, 172 (47.7%) smear negative pulmonary TB, 3 (0.8%) miliary TB, and 87 (24.1%) extra-pulmonary TB.
The clinic registered 919 PLWHA during the first 6 months (November 2001 to April 2002). Excluding 8 (0.9%) under TB treatment, 911 (99.1%) were screened for TB and followed for 12 months. The first screening detected 169 TB cases (18.6%). During this 12-month time, 140 (15.4%) were died and 131 (14.4%) were moved out. The number of returnee for the screening after 12 months was 299 (32.8%). Incidence rate of TB was 14.1 per 100 person-years.
Outcomes of TB treatment from the same cohort showed 57.5% of cure rate and 32.5% of death rate. Among smear negative TB and extra-pulmonary TB patients, death rate (18.4%) and defaulter rate (15.2%) was also high, leading to 62.7% of them to complete TB treatment.
Conclusions: Regular TB screening for PLWHA with better access to quality DOTS is essential in the setting with high prevalence of both TB and HIV, and prophylaxis for other opportunistic infections during TB treatment should be considered.
The XV International AIDS Conference
" M Tamura , , et al.
High prevalence/incidence of TB and poor outcomes of TB treatment among people living with HIV/AIDS (PLWHA) in Phnom Penh, Cambodia.
The XV International AIDS Conference: