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Decline in adverse outcomes and death in tuberculosis patients in Malawi: association with HIV interventions
Authors:H. Kanyerere  A. Mganga  A. D. Harries  K. Tayler-Smith  R. Zachariah  A. Jahn  F. M. Chimbwandira  J. Mpunga
Abstract: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.
Keywords:tuberculosis outcomes   death   Malawi   HIV/AIDS   antiretroviral therapy
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