Clinical manifestation and treatment of multi drug resistant tuberculosis among HIV patients in the people of Ethiopia

Dr. R. Periasamy and Dr. Kashay

Abstract Background: Ethiopia ranks 7th of 22 countries with a huge burden of TB many patients live
beyond far from health facilities and usually delayed for very late investigation and treatment. In 2011, there were 8.7 million new cases of active tuberculosis worldwide (13% involved in coinfection with human immunodeficiency virus) and 1.4 million deaths, including 430,000 incident deaths among HIV infected patients. HIV increases the risk of TB by two to three times and adversely affects TB treatment outcomes. HIV co-infection poses special challenges to clinical management in patients with active tuberculosis. The risk of active tuberculosis increases soon after infection with HIV. Patients with AIDS compared to immune competent ones present with disease patterns that are different in nature, clinical manifestation and treatment.

Objective: To study the clinical profile of multi drug resistant tuberculosis among HIV
patients compared with HIV patients without tuberculosis in general population of Ethiopia.

Methods: Retrospective study of 100 patients in five different hospitals with multi drug
resistant tuberculosis with HIV infection and equal population of patients without tuberculosis for a period of three years.

Results: Hundred patients having symptomatic HIV infection with and without tuberculosis
were studied. Their ages ranged from 30 to 50 years were selected. Patients were divided into two categories as urban and rural areas. The major clinical manifestation was cough and difficult

breathing and night sweating. Fever and weight loss was seen in some patients. Commonly seen physical findings on admission were chronic cough, hepatomegaly, fever, respiratory distress, generalized lymphadenopathy and splenomegaly. Most of the patients were underfed. The

mortality of patients due to tuberculosis, pneumonia, skin lesions, oral thrush and chronic ear infection.

Conclusion: The clinical manifestations of HIV infection supersede by chronic illness of

tuberculosis. Early diagnosis and management of tuberculosis may prolong the lifetime with the current treatment protocol.