Tuberculosis lymphadenitis and HIV/AIDS infections among tuberculosis lymphadenitis presumptive patients in Northwest Ethiopia

Yohannes Zenebe^1,4*, Yesuf Adem¹, Begna Tulu¹,Wondemagegn Mulu¹, Daniel Mekonnen^1,4, Getachewu Muluken², Bayeh Abera¹, Bewuket Abebe³, Awoke Derbie¹, Fnantahun Biadglegne¹

¹Department of Medical  Laboratory Sciences, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia.

²Department of Pathology, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia.

³Department of Pathology, University of Gondar Hospital, Gondar, Ethiopia.

⁴ Biotechnology Research Institute, Bahir Dar University,Bahir Dar, Ethiopia.

*Corresponding Author

Yohannes Zenebe

E-mail:yohabt22@gmail.com; Cell phone: +251 918 704688, P.O.Box: 79, Bahir Dar University, Bahir Dar, Ethiopia

Abstract

Background information: Tuberculosis (TB) is one of the leading causes of death worldwide. According to the hospital statistical data of the Ethiopian Federal Ministry of Health (EFMOH) TB is the leading cause of morbidity, the third cause of hospital admission and the second cause of death in Ethiopia. Assessing the rate of TB lymphadenitis and HIV infections will be helpful for appropriate interventions that will reduce mortality, morbidity and other complications.

Methods: An institutional based cross sectional study was conducted from October 2015 to February 2016 in the selected hospitals of Amhara regional state. Data on demographic and other related variables were collected with pre-tested standardized questionnaire. Fine needle aspirates (FNA) was collected by senior pathologist and processed for pathological and microbiological culture based on the standardized procedures. Microscopic examination was done on cytomorphological staining.  To detect HIV, the anti-HIV antibody test was used according to the manufacturer’s instructions. Data entry and analysis was made using SPSS version 20 statistical packages. A stepwise logistic regression model was used. Odds Ratio (OR), p-value and their 95% Confidence Intervals (CI) were calculated and the result was considered statistically significant at P<0. 05.

Results:  A total of 381 presumptive TB lymphadenitis (TBLN) patients were included in this study. The overall prevalence of TBLN and HIV were at 250(65.6%) and 9(2.4%), respectively. The co-infection proportion was at 6(2.4%).  From the pathological examination, 301(79.0%) of them were diagnosed as TBLN; but only 217(60.0%) of them were culture confirmed TB. The patient age group, (P=0.01) and residency, (P=0.01) were found significantly associated with TBLN. Similarly, unsafe sex was also statistically significant for HIV infection (P=0.007).

Conclusion: The prevalence of TBLN in the study area is still high. However, TBLN/HIV co-infection was promisingly low. There is a discrepancy on diagnostic results of pathological and culture method. Hence it is recommended to add different diagnostic techniques for the appropriate patient treatment.

Key words:  TBLD, HIV, Ethiopia