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Incidence of tuberculosis among HIV-positive adults on antiretroviral therapy at Debre Markos Referral Hospital, Northwest Ethiopia: A retrospective cohort study

Abstract Background: Tuberculosis is the leading cause of morbidity and mortality among people living with human immunodeficiency virus. Almost one-third of deaths among people living with human immunodeficiency virus are attributed to tuberculosis. 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: An institution based retrospective cohort study was conducted among 544 HIV-positive adults on ART at Debre Markos Referral Hospital from January 1, 2012 to December 31, 2017. The study participants were selected using a simple random sampling technique. The data extraction format was adapted from ART intake and follow-up forms. Data were entered using Epi-Data version 4.2 and analyzed using STATA Version 13. Tuberculosis free survival time was estimated using the Kaplan-Meier survival curve. Both the bi-variable and multivariable Cox-proportional hazard regression models were used to identify predictors of the time to develop TB. Results: Among 492 HIV-positive adults included in the final analysis, 16.9% of them developed TB at the time of follow up. 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 of the time to develop TB. Conclusion: In this study, a high incidence rate of TB was observed among HIV-positive adults. 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. Keywords: HIV, Incidence, Predictors, TB

Springer Science and Business Media LLC

Belisty Temesgen Getiye Dejenu Kibret Nakachew Mekonnen Alamirew Animut Alebel

2019

Title: Incidence of tuberculosis among HIV-positive adults on antiretroviral therapy at Debre Markos Referral Hospital, Northwest Ethiopia: A retrospective cohort study

Description:

Abstract Background: Tuberculosis is the leading cause of morbidity and mortality among people living with human immunodeficiency virus.

Almost one-third of deaths among people living with human immunodeficiency virus are attributed to tuberculosis.

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: An institution based retrospective cohort study was conducted among 544 HIV-positive adults on ART at Debre Markos Referral Hospital from January 1, 2012 to December 31, 2017.

The study participants were selected using a simple random sampling technique.

The data extraction format was adapted from ART intake and follow-up forms.

Data were entered using Epi-Data version 4.

2 and analyzed using STATA Version 13.

Tuberculosis free survival time was estimated using the Kaplan-Meier survival curve.

Both the bi-variable and multivariable Cox-proportional hazard regression models were used to identify predictors of the time to develop TB.

Results: Among 492 HIV-positive adults included in the final analysis, 16.

9% of them developed TB at the time of follow up.

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 of the time to develop TB.

Conclusion: In this study, a high incidence rate of TB was observed among HIV-positive adults.

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.

Keywords: HIV, Incidence, Predictors, TB.

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Incidence of tuberculosis among HIV-positive adults on antiretroviral therapy at Debre Markos Referral Hospital, Northwest Ethiopia: A retrospective cohort study

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