Optimizing the diagnosis and management of tuberculosis and assessing the burden of hypertension among HIV patients in a high TB and HIV burden setting

Background: TB is the commonest cause of death among people living with HIV (PLHIV) in Nigeria. It is difficult to diagnose TB among PLHIV and diagnosed patients often experience poor treatment outcome. Although, PLHIV are living longer because of increased access to antiretroviral therapy (ART), hypertension is emerging as a major co-morbidity in this population. This study explored better means of diagnosing TB among individuals with and without HIV, described TB treatment outcomes and their determinants, and assessed the burden of hypertension among PLHIV. Methods: This thesis comprises four studies conducted in University of Abuja Teaching Hospital (UATH): one cross-sectional study of PLHIV to assess the performance of the WHO TB symptom screening algorithm; a prospective study to evaluate whether C-reactive protein (CRP) and Interferon gamma-inducible protein 10 (IP-10) could be used to screen individuals for TB; a retrospective study to describe the TB treatment outcome of PLHIV and HIV-negative patients and the risk factors for poor treatment outcome and a retrospective study to describe the prevalence and incidence of hypertension and its determinants among PLHIV registered over a period of 3 years. ... (continues)