Treatment Outcome of Tuberculosis and Associated Factors Among MTB/HIV Co-infected Patients in Sichuan, China: A Cross-Sectional Study (2016-2020)

Abstract Background: Mycobacterium tuberculosis/Human immunodeficiency virus (MTB/HIV) co-infection has increasingly become a pressing global public health problem. TB patients co-infected with HIV have poorer treatment outcome as compared to non-HIV-infected TB patients.This study was conducted to assess the outcomes of TB treatment and their associated factors among MTB/HIV co-infected patients in Sichuan, Southwest of China. Methods: A cross-sectional study was performed among all of the MTB/HIV co-infected patients who were diagnosed and registered in TB designated hospitals and health facilities in Sichuan from 1 st January 2016 to 31 st December 2020. The data was collected from patients’ electronic medical records regarding patients’ demographic, clinical as well as their social support information. We calculated proportions of factors and treatment outcomes by Pearson’s chi-square test and Fisher’s exact test. Binary logistic regression model was fitted to identify factors associated with unsuccessful TB treatment outcome. For the logistic regression performed using alpha=0.05, odds ratios and corresponding 95% confidence intervals were calculated for the various risk factors. Results: We included a total of 3183 registered MTB/HIV co-infected patients. Of the total patients, 89.54% had successful outcomes, 10.46% had unfavourable outcomes. Of the total successful outcomes, 21.49% were cured, 68.05% had completed their treatment. Being above 60 years old, received TB treatment at the municipal medical institute [AOR=2.093, 95%CI:1.219-3.593], diagnosed with EPTB [AOR=2.067, 95% CI:1.503-2.842], Relapsed or returned treatment after default [AOR=1.593, 95%CI:1.048-2.420], being sputum smear positive [AOR=1.636, 95%CI: 1.290-2.075] were the factors that resulted the patients in unsuccessful treatment outcome. Conclusion: Particular attention is recommended for MTB/HIV co-infected patients who are over 60 years old, receiving medical aid in the city-level medical institute, EPTB, relapsed or returned after default, sputum smear positive. National TB programme should strengthen social support and collaborative MTB/HIV management activities that would trace the identified factors in TB and HIV/AIDS designated health facilities to improve successful treatment outcome of TB.