This study assessed implementation status of collaborative TB/HIV services in Addis Ababa City Administration aiming to promote better implementation strategies. The study employed mixed research methods and was descriptive. The study design used both quantitative and qualitative data using structured questionnaires and semi-structured interview guides, respectively. The study population for the quantitative design included 1,683 TB/HIV patients from 10 conveniently selected health facilities: Zewditu and Menelik Hospitals, health centres of Lideta, Yeka, Kazanchis, NifaSilk-Lafto-No1, Woreda-7, Kality, Bole and Gulele. All the patients who were on their follow-up cares during the data collection period were interviewed. Participants for qualitative design were 1,650 TB/HIV patients for short answered questions; 8 FGDs among patients; interview of 10 TB/HIV care facility coordinators/health workers and one regional TB/HIV care coordinator, all purposively selected. Quantitative data was analysed using SPSS 15.0, while qualitative data were thematically analysed manually. Majority of HIV patients (92.8%) self-reported that they had been screened for TB; of which, 11.2% were diagnosed for active TB during their follow-up cares. Whereas, 87.1% of TB patients had been offered for HIV test; 79.8% tested; 20.2% tested positive. Knowledge on TB and HIV diseases, transmission and prevention was found to be low. However, participants appreciated the support of the healthcare delivery system in improving their health. Collaborative TB/HIV activities brought additional on-the-job training for healthcare workers; improved flow of logistics and re-arrangement of infrastructures of facilities. The study revealed that, implementation of collaborative TB/HIV activities in Addis Ababa need boosting. The study recommends the need for coordinated efforts of all stakeholders for improving implementation of collaborative TB/HIV care services, as identified by this study. The contribution of this study developed pocket-guide for healthcare workers on collaborative TB/HIV care services, which provides guidance in promoting better TB/HIV care / Health Studies / D. Litt. et Phil. (Health Studies)

The purpose of this study was to determine and compare the outcomes of tuberculosis (TB) treatment among Human Immunodeficiency Virus (HIV) co-infected TB patients, and identify factors associated with these outcomes. A quantitative cross-sectional analytic design was used. Patient level secondary data was collected and analysed for the study. A total of 575 TB patients, including 360 non-HIV infected, 169 HIV co-infected and 46 without a documented HIV status, were enrolled. The overall treatment success rate was 91.5%, and HIV co-infected TB patients had a high rate (11.8%) of unfavourable outcomes. The cure rate was significantly lower (10.1% versus 24.2%) and the death rate higher in HIV co-infected patients (8.3% versus 2.5%). Age and TB classification were significantly associated with treatment outcome. No association was found with starting ART, Cotrimoxazole prophylactic treatment or enrolment in HIV care, but 22% of HIV co-infected TB patients were taking ART when they developed TB disease / Health Studies / M.A. (Public Health)

Purpose: The purpose of this study is to assess risk factors associated with TB co-infection in HIV/AIDS patients taking antiretroviral therapy (ART). Methodology: An observational, analytic, case-control and quantitative study was conducted on a randomly selected 367 HIV and AIDS patients of whom 92 of them were TB co-infected. Data collection was done by using self-structured questionnaire. Result: In this study, educational status, waste disposal system, monthly income, contact history with a patient of active tuberculosis or presence of a family member with active tuberculosis, drug adherence, knowledge on tuberculosis prevention and history of exposure to substance were factors independently associated with the occurrence of active tuberculosis among HIV and Aids patients taking ART. Conclusion: The findings highlight the need for on-going educational, informational and other interventions to address the risk factors of tuberculosis in HIV and Aids patients in order to decrease the rate of TB co-infection / Health Studies / M.A. Public Health

The purpose of this study was to determine and compare the outcomes of tuberculosis (TB) treatment among Human Immunodeficiency Virus (HIV) co-infected TB patients, and identify factors associated with these outcomes. A quantitative cross-sectional analytic design was used. Patient level secondary data was collected and analysed for the study. A total of 575 TB patients, including 360 non-HIV infected, 169 HIV co-infected and 46 without a documented HIV status, were enrolled. The overall treatment success rate was 91.5%, and HIV co-infected TB patients had a high rate (11.8%) of unfavourable outcomes. The cure rate was significantly lower (10.1% versus 24.2%) and the death rate higher in HIV co-infected patients (8.3% versus 2.5%). Age and TB classification were significantly associated with treatment outcome. No association was found with starting ART, Cotrimoxazole prophylactic treatment or enrolment in HIV care, but 22% of HIV co-infected TB patients were taking ART when they developed TB disease / Health Studies / M.A. (Public Health)

Purpose: The purpose of this study is to assess risk factors associated with TB co-infection in HIV/AIDS patients taking antiretroviral therapy (ART). Methodology: An observational, analytic, case-control and quantitative study was conducted on a randomly selected 367 HIV and AIDS patients of whom 92 of them were TB co-infected. Data collection was done by using self-structured questionnaire. Result: In this study, educational status, waste disposal system, monthly income, contact history with a patient of active tuberculosis or presence of a family member with active tuberculosis, drug adherence, knowledge on tuberculosis prevention and history of exposure to substance were factors independently associated with the occurrence of active tuberculosis among HIV and Aids patients taking ART. Conclusion: The findings highlight the need for on-going educational, informational and other interventions to address the risk factors of tuberculosis in HIV and Aids patients in order to decrease the rate of TB co-infection / Health Studies / M.A. Public Health

Thesis (Ph.D. (Nursing Science)) -- University of Limpopo, 2017 / The aim of this study was to develop a model to ensure the integration of Tuberculosis (TB) and Human Immune Deficiency Virus (HIV) services in the Primary Health Care (PHC) facilities of Limpopo Province. An explanatory sequential mixed method was used in this study to develop a model for ensuring the integration of TB and HIV services in the PHC facilities of the Limpopo Province. The researcher collected quantitative data followed by qualitative data. Quantitative data was collected through administration of questionnaires to 450 PHC nurses in the five districts of Limpopo Province. The qualitative data was collected by conducting focus group discussions to five groups of Community Home Based Carers (CHBCs) and five groups of TB/HIV co-infected patients in the five districts of Limpopo Province. Audiotape and field notes were used to capture verbal and non-verbal cues. The Statistical Package for Social Sciences (SPSS) computer programme version 22.0 was used for capturing and analysis of the quantitative data. Content analysis was used to analyse the qualitative data from the CHBCs and the TB and HIV co-infected patients’ focus group discussions. The study revealed lack of knowledge and skills on TB and HIV management due to insufficient training of PHC nurses about TB and HIV management. Staff shortage of PHC nurses in the facilities was also indicated by PHC nurses. Furthermore, TB and HIV coinfected patients are faced with challenges in the PHC facilities and in the community. Challenges that are faced by CHBCs and the TB and HIV co-infected patients include negative attitudes of some clinic staff members towards them. The patients’ families also have some negative attitudes towards the CHBCs as they leave the patients to them without assisting them in the caring duties. The community members also has negative attitudes as they do not accept the CHBCs in their homes to support the patients. Based on the results, a model was developed to ensure the integration of TB and HIV services. The model was validated by PHC nurses and the experts in research and model development. The validation results showed that the model was clear and simple to be used in the PHC facilities for integration of TB and HIV services. The study recommends that the model should be used by PHC facilities for integration of TB and HIV services. The PHC nurses should attend TB and HIV capacity-building courses.

<p dir="ltr">Tuberculosis (TB), caused by <i>Mycobacterium tuberculosis</i> (<i>Mtb</i>), and human immunodeficiency virus-1 (HIV) are major public health concerns, individually and in combination. The status of the host immune system, previous <i>Mtb</i> infection and HIV-mediated T cell exhaustion, can have significant impacts on immune dynamics during reinfection. Individuals with asymptomatic latent TB infection (LTBI) may be protected against <i>Mtb </i>reinfection, as demonstrated by animal and <i>in vitro </i>studies. However, the underlying dynamics and protective mechanisms of LTBI are poorly understood. In HIV, long-term infection in children and associated T cell exhaustion leads to weakened immune responses to HIV reinfection. The complexity of these infections, particularly in the context of the heightened vulnerability of HIV+ individuals to TB, underscores the need for novel investigative approaches to study host-pathogen and pathogen-pathogen interactions. To this, we have developed an agent-based model (ABM) as a mechanistic computational tool to simulate the immune response to <i>Mtb </i>and HIV, separately and during coinfection. Our ABM integrates clinical and experimental data; simulates immune cell dynamics between macrophages, CD4+ and CD8+ T cells; and produces emergent granuloma-like structures – a critical response to <i>Mtb</i>. This <i>in silico</i> approach allows us to efficiently explore host-pathogen interactions and their clinical implications. By unraveling the complex interplay of immune cell activation, T cell exhaustion, and pathogen dynamics, our model offers insights that could guide the development of targeted therapies. By quantifying the multifaceted nature of these diseases and their interactions, we highlight the potential of computational approaches in understanding and treating complex diseases, individually and in combination.</p>