HIV TB Co-Infection in the Development of Drug Resistant TB at Three Major Referral Hospitals in Southern Ghana

Abstract

Introduction: Tuberculosis (TB) remains an important cause of human suffering and death. The impact of Human immunodeficiency virus (HIV) on TB, drug resistant TB (DR-TB) and the implications for TB control, has been acknowledged as a major public health challenge. The influence of HIV/TB co-infection in the development of DR-TB has not yet been fully investigated in this part of the world. Objective: The aim of this study was to determine the role of HIV/TB co-infection in the development of drug resistant TB at three major referral hospitals in Southern Ghana. Methodology: A descriptive cross-sectional analysis of TB data at the Greater Accra Regional Hospital, the Korle-Bu Teaching Hospital and the Eastern Regional Hospital was conducted using databases of their TB Registry spanning the period of February 2013 to December 2017. Results: A total of 9722 Tuberculosis (TB) patients diagnosed were reviewed. HIV prevalence was significantly high 30.0% (p<0.001). Drug resistant-TB prevalence was 101(1.0%). Previous TB treatment was associated with drug resistant-TB development (p<0.001). Drug resistance TB patients were more likely to have had previous TB treatment (AOR=348.61, CI=153.71-790.60). Patients with drug resistant TB had reduced odds of being HIV positive (AOR=0.69, CI=0.39-1.22). This was however and was not statistically significant (p=0.215). Conclusion: At 1.0%, the prevalence of drug resistant-TB in the 3 study sites was low. There was no significant association between HIV infection and the development of TB drug resistance. However, there was a statistically significant association between previous TB treatment and TB drug resistance.