Prevalence and predictors of unsuccessful tuberculosis treatment outcomes among persons with TB/HIV co-infection in Ghana: a 10-year retrospective study

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INTRODUCTION: Unsuccessful treatment outcomes significantly impact tuberculosis control efforts globally particularly among individuals co-infected with Human Immunodeficiency Virus (HIV). This study aimed to assess the prevalence, trends, and associated factors of unsuccessful Tuberculosis (TB) treatment outcomes among persons with TB/HIV co-infection at Komfo Anokye Teaching Hospital in Ghana over a 10-year period. METHODS: A retrospective cross-sectional study was conducted using data from the Komfo Anokye Teaching Hospital between January 2012 and December 2022. A total of 1,242 persons with TB/HIV co-infection were included in the study. Unsuccessful treatment outcomes were defined as death, treatment failure, or default. Modified Poisson regression with robust standard errors was performed using Stata version 17.0 to identify predictors of unsuccessful outcomes. Crude and adjusted relative risk ratios with 95% confidence intervals (CI) were reported, and a p-value < 0.05 was considered statistically significant. RESULTS: The prevalence of unsuccessful treatment outcomes for the 10-year period was 24.6% (95% CI: 22.3-27.1). The analysis revealed a decreasing trend of unsuccessful TB treatment outcomes from 47.6% in 2012 to 7.79 in 2022. In the multivariable analysis, older age (≥ 65 years) was associated with a higher risk of unsuccessful outcomes (ARR: 5.6, 95% CI: 2.8-11.1). Conversely, pretreatment weights of 40-54 kg (ARR: 0.5, 95% CI: 0.3-0.7), 55-69 kg (ARR: 0.4, 95% CI: 0.3-0.6), and ≥ 74 kg (ARR: 0.2, 95% CI: 0.1-0.7) were associated with reduced risk. The presence of a treatment supporter also lowered the risk of unsuccessful outcomes (ARR: 0.8, 95% CI: 0.6-0.9). CONCLUSION: The high prevalence of unsuccessful TB treatment outcomes among persons with TB/HIV co-infection within the 10-year period highlights the need for targeted interventions. Prioritizing care for older patients, improving nutritional support, and promoting treatment supporter involvement will enhance treatment success in Ghana. CLINICAL TRIAL NUMBER: Not applicable.

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