Clinical Deterioration during Antitubercular Treatment in South Africa
Author Information
Author(s): Pepper Dominique J., Rebe Kevin, Morroni Chelsea, Wilkinson Robert J., Meintjes Graeme
Primary Institution: University of Cape Town
Hypothesis
What are the reasons for clinical deterioration in tuberculosis patients undergoing antitubercular treatment in a high HIV-1 prevalence setting?
Conclusion
New AIDS defining illnesses, drug resistant M.tb, and other drug resistant bacteria are significant reasons for clinical deterioration in HIV-1 co-infected patients receiving antitubercular treatment.
Supporting Evidence
- 296 out of 352 TB patients were admitted to the hospital, accounting for 17% of total medical admissions.
- Mortality among TB patients admitted to hospital was 16%.
- 72% of TB patients had an additional illness to tuberculosis.
Takeaway
This study looked at why some people with tuberculosis get worse while being treated, especially those who also have HIV. It found that other illnesses and drug-resistant bacteria are big problems.
Methodology
A prospective observational study conducted at GF Jooste Hospital, collecting data on TB diagnosis, treatment, HIV-1 status, and reasons for clinical deterioration.
Potential Biases
Referral bias due to strict admission criteria may affect the generalizability of the findings.
Limitations
The study design within routine care in a busy setting may lead to referral bias and underestimation of the problem.
Participant Demographics
83% of TB patients were HIV-1 co-infected, with a median CD4 count of 89 cells/mm3.
Statistical Information
P-Value
p<0.05
Confidence Interval
95% confidence interval: 9–11%
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
Want to read the original?
Access the complete publication on the publisher's website