Predictors of tuberculosis infection among adults visiting anti-retroviral treatment center in East and West Gojjam Zone, northwest, Ethiopia, 2017

Abstract Background: Tuberculosis is a serious health threat, especially for people living with human immune deficiency virus worldwide and the burden of TB/HIV infection is still high in Ethiopia in particular. Objective: To determine the predictors of tuberculosis infection among adults visiting anti-retroviral treatment center in East and west Gojjam, Northwest Ethiopia, 2017Methods: An institution based unmatched case-control study was conducted in East and West Gojjam Zone, Northwest, Ethiopia from March 7-April 15, 2017. Cases were 139 tuberculosis infected human immune deficiency virus positives and controls were 413 non-TB infected HIV positives i.e. 1:3 proportion. All cases in each health facility who confirmed by acid-fast bacilli (direct microscopy), culture and gene expert were considered as TB positive fine needle aspiration. However controls were selected by using simple random sampling technique through the above diagnostic criteria and the data were collected with Face to face interview as well as patient medical record were used and the quality of the data were assured, checked, coded, cleaned and entered in EPI-Data version 3.1 and exported to SPSS version 20 for the analysis. Result: Of the total sample (556), just about 552(99.2%) were participated in the study among this 47.5% were females and 58.9% were rural. Behavioral and modifiable biological risk factors: alcohol users (AOR=2.33; 95% CI:1.34,4.07), BMI<18.5kg/m2 (AOR=3.03;95%CI:1.79,5.14), CD4 count ≤200 cells/µl (AOR=2.34;95%CI:1.89,2.79) and between 201-499 cells/µl (AOR=2.63; 95%CI: 1.01,6.84), bedridden and ambulatory (AOR=3.3;95%CI:1.70,6.29 and AOR=8.2;95%CI:4.34,15.64),respectively. TB history in the family (AOR=3.00; 95%CI: 1.57, 5.74) were predictors for TB infection. Taking CPT (AOR=0.36; 95%CI: 0.21, 0.62) and having early WHO clinical stage I or II (AOR=0.34; 95%CI: 0.20, 0.56) had protective effect against TB infection. Conclusion &Recommendation: Behavioral, biological, clinical and TB history in the family were highly prevalent in the study area. Strengthen screening more frequently, CPT Prophlaxysis and treated promptly important to reduce TB co-morbidity.