Risk Factors for Mortality in Patients with TB/HIV Co-Infection at the General Provincial Reference Hospital of Kinshasa, Democratic Republic of the Congo
Author(s): Palambwa Ansot Anzats Ruphine, Nsutier Kolnziam Oscar, Gédéon Ngiala Bongo, Nsobani Lukelo Désiré and Amuli Jiwe JeanPierre
Background: The HIV (human immunodeficiency virus) pandemic has been accompanied by an increase in the incidence of many opportunistic infections like tuberculosis (TB). Despite curative and preventive efforts and free treatment for TB -HIV co-infection, the Democratic Republic of Congo remains the fourth country in Africa where the prevalence of this co-infection remains very high. The aim of this study was to identify the factors that explain mortality in patients with TB/HIV co-infection at the Kinshasa Provincial General Reference Hospital in order to reduce the incidence of complications related to this century's pandemic.
Methods: The survey was conducted at the General Provincial Reference Hoisptal of Kinshasa (GPRHK), Kinshasa, DR Congo. This cross-sectional study was conducted between January and November 2018, whereby medical files for patients suffering from TB/HIV co-infection were analyzed. The sample size was determined on the basis of the Fischer formula. Thus, one hundred and forty-four (144) files were selected and consulted. Data were collected based on a pre-established, standardized and anonymous questionnaire. This questionnaire was tested on a sample of 40 files subsequently validated. Descriptive analyses were used to describe the sample profile. The correlational analysis using the Chi-square association test (X2), the confidence interval of the Odds-ratio was performed between different variables. All data were analyzed using SPSS software version 22.0. The p value < 0.05 was considered statistically significant.
Results: Multiple regression analysis indicates that the main determinants of mortality in patients with TB/HIV co-infection are as follows: the main predictors of mortality from TB/HIV co-infection were, in order of importance, patients diagnosed with HIV (0.448; p0.05), patients treated with anti-tubercular drugs (0.231; p0.05). The clinical form of tuberculosis ( -0.032; p0.05) and the age of people living with HIV (0.038; p0.05) are not significantly associated with TB-HIV co-infection.
Conclusion: The diagnosis of HIV infection in TB patients in the absence of anti-tuberculin prophylaxis, followed by the clinical form of tuberculosis coupled with poor compliance and significant immunosuppression are the major risk factors for mortality.