Association between tuberculosis treatment outcomes and the mobile antiretroviral therapy programme in Zambia

Int J Tuberc Lung Dis. 2013 Apr;17(4):540-5. doi: 10.5588/ijtld.12.0432. Epub 2013 Feb 7.

Abstract

Setting: Free antiretroviral therapy (ART) services in Zambia were introduced in hospitals beginning in 2005 and in selected rural health centres (RHCs) beginning in 2007 through the mobile ART programme.

Objective: To analyse the impact of scaling up ART services on tuberculosis (TB) treatment outcomes in Mumbwa District, Zambia.

Design: TB patients registered at all RHCs in the district between July 2006 and September 2009 were reviewed. RHCs were divided into two groups: 'ART sites', which provided ART services after 2007, and 'non-ART sites', which did not provide such services even after 2007. A before-after comparison analysis of TB patients was conducted between the groups.

Results: A total of 732 patients were enrolled (median age 34.5 years; female 44.4%). The overall human immunodeficiency virus (HIV) testing rate was 72.3% and 66.7% of these patients were HIV-positive. The TB treatment success rate at the ART sites increased significantly compared to non-ART sites after the mobile ART programme was started (P < 0.01). The HIV testing acceptance rate also increased dramatically at ART sites, which facilitated intensified case finding (P = 0.02).

Conclusion: Scaling up ART services in rural health facilities through the mobile ART programme was found to be associated with greatly improved anti-tuberculosis treatment outcomes.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Retroviral Agents / therapeutic use*
  • Antitubercular Agents / therapeutic use*
  • Chi-Square Distribution
  • Child
  • Child, Preschool
  • Coinfection*
  • Developing Countries
  • Female
  • HIV Infections / diagnosis
  • HIV Infections / drug therapy*
  • HIV Infections / epidemiology
  • Health Resources
  • Health Services Accessibility*
  • Humans
  • Infant
  • Male
  • Middle Aged
  • Mobile Health Units*
  • Program Evaluation
  • Registries
  • Retrospective Studies
  • Rural Health Services*
  • Time Factors
  • Treatment Outcome
  • Tuberculosis / diagnosis
  • Tuberculosis / drug therapy*
  • Tuberculosis / epidemiology
  • Young Adult
  • Zambia / epidemiology

Substances

  • Anti-Retroviral Agents
  • Antitubercular Agents