Last modified: 2019-02-13
Abstract
Background: Tuberculosis is the leading cause of morbidity and mortality among people living with human immunodeficiency virus. Despite this fact, in Ethiopia, particularly in our study area there is a scarcity of information regarding the incidence and predictors of TB among peoples living with HIV. Thus, this study aimed to assess the incidence and predictors of tuberculosis among HIV positive adults.
Methods: Aninstitution based retrospective cohort study was conducted among 544 HIV positive adults on ART at Debre Markos Referral Hospital. The data extraction format was adapted from ART intake and follow up forms. Data were entered into Epi-Data version 4.2 and analysis was done using STATA Version 13. The Kaplan-Meier survival method was used to estimate the TB free survival time. Log-rank tests were used to compare the survival curves of different categorical explanatory variables.Both the bi-variable and multivariable Cox-proportional hazard regression models were used to identify predictors of the time to develop TB.
Results: At the end of follow-up, 16.9% of the study participants developed TB. The incidence rate of TB was found to be 6.5 (95%CI: 5.2, 8.0) per 100-person years. Advanced WHO clinical disease stage (III and IV) (AHR: 2.1, 95% CI: 1.2, 3.2), being ambulatory and bedridden (AHR: 1.8, 95% CI: 1.1, 3.1), baseline opportunistic infections (AHR: 2.8, 95% CI: 1.7, 4.4), low hemoglobin level (AHR: 3.5, 95% CI: 2.1, 5.8), and not taking IPT (AHR: 3.9, 95% CI: 1.9, 7.6) were found to be predictors to develop TB.
Conclusion: There was a high rate of TB occurrence as compared to previous studies conducted in Ethiopia. Advanced HIV disease stage (III and IV), being ambulatory and bedridden, having opportunistic infections, having a low hemoglobin level, and not taking IPT were found to be predictors of the time to develop TB.