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Vol. 14. Issue 6.
Pages 594-600 (November - December 2010)
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Vol. 14. Issue 6.
Pages 594-600 (November - December 2010)
Original article
Open Access
Assessment of the effectiveness of a home-based care program for patients coinfected with tuberculosis and human immunodeficiency virus after discharge from a reference hospital in South-Eastern Brazil
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Carlos Alessandro Plá Bento1,
Corresponding author
plabento@uol.com.br

Correspondence to: Hospital Eduardo de Menezes, Rua Dr. Cristiano Resende, 2213 – Bonsucesso, 30622-020, Belo Horizonte, MG, Brazil. Fax: 55 31 3328 5029.
, Enio Roberto Pietra Pedroso2
1 Master's Degree in Tropical Medicine at Health Science's (Infectology and Tropical Medicine) Postgraduate Course by the Medicine School of Universidade Federal de Minas Gerais. Hospital Eduardo de Menezes (HEM) - Fundação Hospitalar do Estado de Minas Gerais (FHEMIG), Belo-Horizonte, MG, Brazil
2 Full Professor at Departamento de Clínica Médica of the Medicine School of Universidade Federal de Minas Gerais - Centro de Pós-Graduação em Medicina Tropical da Faculdade de Medicina da Universidade Federal de Minas Gerais (FM-UFMG), Belo-Horizonte, MG, Brazil
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Abstract

The effectiveness of tuberculosis treatment delivered by a home-based care program to patients coinfected with HIV was compared with that of a service provided by outpatient departments. A retrospective study was made of a cohort of coinfected patients discharged from hospital between January 1998 and December 2002 who had been followed-up for one year within one of these programs. Two-hundred-and-forty-three patients who met the inclusion criteria were grouped according to their treatment program (group 1 received home-based care; group 2 attended outpatient departments) and then paired one-to-one across the groups by gender, age and level of education. Only 48 patients from each group could be paired. Apart from the duration of HIV infection, there were no statistically significant differences (P < 0.05) between patients in the two groups with respect to social-demographic status and clinical or laboratory characteristics. In group 1, 75.0% of patients attained successful tuberculosis treatment compared with 72.9% of those in group 2 (P = 0.816). Treatment was abandoned by 22.9% of patients in group 1 and by 54.2% of those in group 2 (P = 0.008). The death rate within one year after discharge was 20.8% for group 1 compared with 6.3% for group 2 (P = 0.334). Although both programs achieved a similar success rate in the treatment of tuberculosis, patients receiving outpatient care were three to eight-times more likely to abandon the program. The importance of assigning patients at-risk of abandoning treatment to a home-based care program after discharge from hospital is emphasized.

Keywords:
AIDS
tuberculosis
treatment outcome
adherence to treatment
home-based care
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