Research Article
Tuberculosis Treatment Outcome in Patients with TB-HIV
Coinfection in Kuala Lumpur, Malaysia
DianaSafraaSelimin,
1
AnizaIsmail ,
1
NorfazilahAhmad ,
1
RohaniIsmail,
2
NurulFarhanaMohdAzman,
2
andAmaleenaAzman
2
1
Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre,
56000 Kuala Lumpur, Malaysia
2
e Federal Territory of Kuala Lumpur and Putrajaya Health Department, 56000 Kuala Lumpur, Malaysia
Correspondence should be addressed to Aniza Ismail; aniza@ppukm.ukm.edu.my
Received 9 March 2021; Revised 7 May 2021; Accepted 25 May 2021; Published 30 May 2021
Academic Editor: Maoshui Wang
Copyright © 2021 Diana Safraa Selimin et al. is is an open access article distributed under the Creative Commons Attribution
License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is
properly cited.
Background. Tuberculosis (TB) is a serious health threat to people living with human immunodeficiency virus (HIV). is study
aimed to identify the characteristics, unsuccessful TB treatment rate, and determinants of unsuccessful TB treatment outcome
among patients with TB-HIV coinfection in Kuala Lumpur. Methods. is was a cross-sectional study. e data of all patients with
TB-HIV in the federal territory of Kuala Lumpur from 2013 to 2017 were collected and reviewed. e data were retrieved from the
national database (TB Information System) at the Kuala Lumpur Health Department from 1 March 2018 to 31 May 2018. Results.
Out of 235 randomly selected patients with TB-HIV, TB treatment outcome was successful in 57.9% (cured and completed
treatment) and unsuccessful in 42.1% (died, failed, or lost to follow-up). Patients who did not receive DOTS (directly observed
treatment, short course) (adjusted odds ratio: 21.71; 95% confidence interval: 5.36–87.94) and those who received shorter
treatment duration of <6 months (aOR: 34.54; 95% CI: 5.97–199.93) had higher odds for unsuccessful TB treatment outcome.
Conclusions. Nearly half of the patients with TB-HIV had unsuccessful TB treatment outcome. erefore, it is important to ensure
that such patients receive DOTS and continuous TB treatment of >6 months. It is crucial to strengthen and widen the coverage of
DOTS, especially among high-risk groups, in healthcare settings. Strict follow-up by healthcare providers is needed for patients
with TB-HIV to gain treatment adherence and for better rates of successful TB treatment.
1.Introduction
It is undeniable that tuberculosis (TB) and human immu-
nodeficiency virus (HIV) coinfection poses a major public
health threat worldwide [1, 2]. Worldwide, it has been es-
timated that more than one-third of people living with HIV
(PLHIV) are infected with TB [2, 3]. Out of 10 million
people infected with TB in 2019, 8.2% was PLHIV [4]. An
estimated 70.0% of PLHIV are from sub-Saharan African
countries [5]. Despite the Southeast Asian Region (SEAR)
experiencing 34% decreased TB incidence among PLHIV
within an 11-year period until 2013, high TB-HIV disease
burden was still observed in Indonesia, Myanmar, ailand,
India, and Nepal [6]. In order to reduce the incidence of TB
disease among PLHIV, 32% PLHIV enrolled for HIV care in
SEAR countries received TB preventive treatment in 2019
[7]. In year 2020, 208000 TB deaths were observed among
PLHIV which was a reduction from 678000 in year 2000 [4].
e prevalence of TB-HIV coinfection in Malaysia was
12.6% on 2010 [8] and the latest in 2019 was 5.9% [9].
Eventhough TB prevalence keeps increasing in Malaysia since
year 2000, the prevalence of TB-HIV coinfection has been
observed to maintain less than 6% since year 2014. In
Malaysia, management of coinfection among PLHIV in
Malaysia incorporates TB screening among PLHIV and HIV
screening among TB patients since 1997. Ministry of Health
of Malaysia has started TB screening in settings such as
prisons and drug rehabilitation centres since year 2013.
Hindawi
Journal of Tropical Medicine
Volume 2021, Article ID 9923378, 10 pages
https://doi.org/10.1155/2021/9923378