Aspects of tuberculosis and HIV diagnosis, care and treatment in Rwandan health facilities: operational studies

This thesis outlines studies that were conducted between 2006 and 2010 in Rwandan clinical and public health settings to respond to some unresolved research priority questions. It describes and analyses sputum completion and conversion rates at two months of treatment and their determinants. It explores determinants of adherence to tuberculosis (TB) treatment, TB mortality and the independent effect of adherence on mortality. It reports and analyses HIV test-uptake before and after the introduction of provider-initiated HIV testing and counselling (PITC), as well as the acceptability of PITC and its barriers towards linkage to HIV care. It also reports patient attrition after HIV diagnosis and analyses factors associated with this. Lastly, it explores the prevalence and determinants of discordant treatment responses in a Rwandan cohort of HIV patients who started combined antiretroviral therapy (cART).