Cardiovascular risk among patients with drug-resistant tuberculosis and HIV in South Africa
Erin R. Whitehouse, PhD, MPH, RN
- Sigma Affiliation
- Nu Beta at-Large
Visits vs Downloads
Visitors - World Map
Top Visiting Countries
Top Visiting Cities
Visits (last 6 months)
Downloads (last 6 months)
Popular Works for Whitehouse, Erin Rachel by View
Popular Works for Whitehouse, Erin Rachel by Download
Problem Statement: South Africa has the highest incidence of drug resistant-tuberculosis (DR-TB) in sub-Saharan Africa and outcomes are poor. Only 54% of patients successfully complete treatment. The prevalence of HIV co-infection and cardiovascular (CVD) risk factors is also increasing. The purpose of this study was to describe cardiovascular risk in DR-TB patients with and without HIV co-infection and the impact of this risk on 6-month DR-TB negative treatment outcomes among patients co-infected with HIV.
Methods: This prospective cohort study was nested within an ongoing cluster randomized trial of nurse case management in 10 DR-TB hospitals in Eastern Cape and KwaZulu-Natal, South Africa. The data were collected between November 2014 and July 2016. The prevalence of CVD risk factors and a non-laboratory based risk score were estimated, compared by HIV status, and used to explore the impact on DR-TB negative treatment outcome among 443 HIV co-infected patients.
Results: Of 900 participants, 53.7% were male, 75.1% were HIV co-infected, and 52.3% had at least one CVD risk factor. Males were more likely to have ever smoked (52.5% vs 7.3%, χ2=207.31, p2=50.97, p=35 years old, patients with a high or moderate CVD risk score were 4.5 times more likely to have an early negative treatment outcome compared with those with low CVD risk.
Conclusions: Except for BMI, individual CVD risk factors did not impact early DR-TB outcomes, although an elevated CVD score did increase risk of negative outcome. Providers should screen and treat patients with CVD risk factors according to evidence-based guidelines. Health systems should provide comprehensive, patient-centered care to improve both DR-TB outcomes and CVD related morbidity and mortality in low- and middle-income countries like South Africa.
Funding provided by: National Institute of Allergy and Infectious Disease, NIH R01 AI104488 (2014-2018); Ruth L. Kirschstein National Research Service Award [NRSA] Individual Predoctoral Fellowship from National Institute of Nursing Research, NIH F31-NR016909 (2016-2018); Sigma Theta Tau International Research Grant (2017-2018)
The Sigma Theta Tau International grant application that funded this research, in whole or in part, was completed by the applicant and peer-reviewed prior to the award of the STTI grant. No further peer-review has taken place upon the completion of the STTI grant final report and its appearance in this repository.
|Review Type||None: Sigma Grant Recipient Report|
|Evidence Level||Cohort Study|
|Research Approach||Quantitative Research|
Cardiovascular Risk Factors;
|CINAHL Subject(s)||AIDS-Related Opportunistic Infections;
Acquired Immunodeficiency Syndrome;
HIV Infections--Prevention and Control--South Africa;
Cardiovascular Risk Factors--Evaluation;
HIV Infections--Prevention and Control;
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.
All permission requests should be directed accordingly and not to the Sigma Repository.
All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
The following license files are associated with this item:
Showing items related by title, author, creator and subjects.
Adverse drug reactions and resultant health-related quality of life during multidrug-resistant tuberculosis treatment in South Africa Kelly, Ana Maria (2015-10-02)Background/Significance: The incidence of multidrug-resistant tuberculosis (MDR-TB) is on the rise globally. MDR-TB takes a minimum of 2 years to treat and the treatment regimen produces many adverse drug reactions (ADRs). ...
Evidence-based clinical guidelines and their impact on prevention of catheter related blood stream infections McCauley, Paula S.The growing concern for hospital-acquired infections in healthcare has stimulated the development of evidence based practice guidelines. Healthcare institutions across the United States are increasing their focus on the ...
Challenges to Providing Patient-Centered Care for Multidrug-Resistant Tuberculosis (MDR-TB) in South Africa Kelly, Ana Maria; Smith, Barbara Ann; Farley, Jason E. (2016-07-13)Session presented on Sunday, July 24, 2016: Purpose: The incidence of multidrug-resistant tuberculosis (MDR-TB) is on the rise globally. MDR-TB takes a minimum of 2 years to treat and the treatment regimen produces many ...
Initiation of a HIV screening protocol and pathway in the emergency department: A quality improvement initiative Davis, Kristina Anne (11/9/2017)There is currently a nationwide campaign to address human immunodeficiency virus (HIV) prevention and treatment. The emergency department (ED) is a significant venue in the HIV prevention and treatment campaign. The quality ...
Assessment of the Provision of Education Materials on HIV/AIDS Prevention among Boys Who Undergo Male Circumcision at Hospitals in the Vhembe District, Limpopo Province, South Africa Mulaudzi, Fhumulani Mavis; Malala, Lufuno Charity (2016-03-21)Session presented on Monday, November 9, 2015 and Tuesday, November 10, 2015: Background: Literature shows the importance of health education coupled with educational materials as important tools towards HIV/AIDS prevention. ...