Determinants for tuberculosis in HIV infected patients in Debre Birhan town, Amhara national regional state, Ethiopia: a case control study

Abstract Abstract Background: Tuberculosis (TB) is one of the most frequent opportunistic infections in people living with the Human Immunodeficiency Virus (HIV). It is a leading cause of morbidity and mortality in high HIV prevalent population. There are various factors contributing for the occurrence of TB/HIV co-infection that are not well studied in this area. The purpose of this study is to assess determinants of Tuberculosis infection among HIV positive patients attending ART clinics in governmental health facilities at Debre Birhan town North Shoa, Ethiopia. Methods: A case control study design was conducted from February 15, 2017 to April 30, 2017 in governmental health facilities at Debre Birhan town. A total of 276 individuals were to participated in this study (92 cases and 184 controls). Cases were adult patients with TB/HIV who were co-infection and controls were adult HIV patients without TB. A pre- tested interviewer administered structured questionnaire was used to collect data on Socio demographic variables, housing characteristics and personal behaviours. Host, clinical and immunological variables were taken from ART card and log books. Result: In this study participants who; earn low monthly income (AOR) 0.024; 95% CI 0.004 to 0.14), smoker (AOR 10.53; 95% CI 1.53 to 72.18), kerosene (AOR 2.49; 95% CI 1.22 to 5.07), alcohol (AOR=5.48; 95% CI 1.29 to 23.56), family history of TB (AOR=2.51; 1.03,6.15) were at high risk of tuberculosis. While patients with opportunistic infections (AOR=3.35; 95% CI 1.62 to 6.91), bronchial asthma (AOR=14.77; 95% CI 6.25 to 34.91), diabetes mellitus (AOR 10.62; 95% CI 2.77 to 40.50) and low CD4 level (AOR=6.03; 95% CI 2.27 to 16.18) were at high risk of TB. Conclusion: HIV patients with risk behaviours, opportunistic infections, diabetes, asthma, low CD4, kerosene user and poor were at risk of TB. To reduce the risk of TB health care providers and government should work to reduce risk behaviours, early screening and initiation of treatment for opportunistic infections, health education for chronic diseases, early staging and initiation of treatment for HIV, working with poor to improve their life were recommended. Key words: Tuberculosis Infection, HIV Patients, Debre Birhan Town, Ethiopia