Time to tuberculosis development and its predictors among HIV-positive patients: A retrospective cohort study

by Abraham Teka Ajema, Yilkal Simachew, Meiraf Daniel Meshesha, Taye Gari

Objectives

To assess the incidence and predictors of time to Tuberculosis (TB) development among Human Immunodeficiency Virus (HIV) positive patients attending follow-up care in health facilities of Hawassa, Ethiopia.

Methods

We conducted a retrospective cohort study from April 1–30, 2023. A total of 422 participants were selected using a simple random sampling method. Data was collected from the medical records of patients enrolled between January 1, 2018 –December 31, 2022, using the Kobo toolbox. We used Statistical Package for Social Studies (SPSS) version 26.0 for data analysis. To estimate the duration of TB-free survival, we applied the Kaplan-Meier survival function and fitted Cox proportional hazard models to identify the predictors of time to TB development. Adjusted hazard ratios (AHR) with 95% confidence intervals were calculated and statistical significance was declared at a P-value of 0.05.

Results

The overall incidence rate of TB among HIV-positive patients was 6.26 (95% CI: 4.79–8.17) per 100 person-years (PYs). Patients who did not complete TB Preventive Therapy (TPT) were more likely to have TB than those who did (AHR = 6.2, 95% CI: 2.34–16.34). In comparison to those who began antiretroviral therapy (ART) within a week, those who began after a week of linkage had a lower risk of TB development (AHR = 0.44, 95% CI: 0.21–0.89). Patients who received ART for six to twelve months (AHR = 0.18, 95% CI: 0.05–0.61) and for twelve months or longer (AHR = 0.004, 95% CI: 0.001–0.02) exhibited a decreased risk of TB development in comparison to those who had ART for less than six months.

Conclusion

The incidence of TB among HIV-positive patients is still high. To alleviate this burden, special attention should be given to regimen optimization and provision of adherence support for better completion of TPT, sufficient patient preparation, thorough clinical evaluation for major (Opportunistic Infections) OIs prior to starting ART, and ensuring retention on ART.

Strategies to improve and enhance satisfaction with learning among nursing students

Background and purpose

This is a summary of Cant R, Gazula S, and Ryan C.1

Student satisfaction is important as it positively influences both student retention and institutional rankings.

The concept of student satisfaction with education is poorly understood, although some studies suggested its related elements such as learning environments; student motivation to learn; student and teacher accountability; classroom diversity, and assessment approaches.

By identifying factors that influence nursing students’ satisfaction, nurse educators will have the opportunity to further improve the curriculum and student education experiences.

This integrative review aims to discover basic conceptual elements that affect higher education students’ satisfaction, focusing on nursing education.

Methods

Results and areas for future research

Twenty-two studies were included: 19 with an experimental, quasi-experimental design and three systematic reviews from 15 countries.

Service quality, institutional image and...