Abstract
Introduction. Tuberculosis is a major public health concern globally, especially in sub-Saharan African countries. It is the most common opportunistic infection and leading cause of mortality among people living with human immunodeficiency virus despite increased deliverance of antiretroviral therapy. Objectives. The aim of this study was to identify determinants of active tuberculosis among adult HIV positive patients after ART initiation in West Showa Zone public hospitals, Ethiopia. Methods. Multicentred unmatched case-control study was conducted on selected public hospitals in West Showa Zone from February to June, 2019. A total of 406 participants (203 cases and 203 controls) were included in the study. Cases were adult HIV patients who developed tuberculosis after ART initiation while controls were adult HIV patients who did not develop tuberculosis after ART initiation. Data were collected using interviewer administered structured questionnaire. Logistic regression analysis was performed using SPSS version 24 statistical software. Statistical significance test was set at 95% confidence level. Results. This study identified that patient’s previous TB history (AOR = 2.41; 95% CI: 1.49, 3.90; P value<0.001), haemoglobin level (AOR = 3.67; 95% CI: 1.98, 6.79; P value<0.001), CD4 cells count (AOR = 2.02; CI: 1.24, 3.29; P value=0.004), adherence level (AOR = 19.00; CI: 5.59, 64.59; P vaue<0.001), and WHO HIV/AIDS clinical stage (AOR = 2.58; CI: 1.59, 4.18; P vaue<0.001) were found to be statistically significant determinants for the occurrence of tuberculosis among PLHIV after ART initiation. Conclusion. Patient’s previous TB history, haemoglobin level, CD4 cells count, adherence level, and WHO clinical stage were significant determinants of occurrence of tuberculosis after ART initiation in PLHIV.
Highlights
Tuberculosis is a major public health concern globally, especially in sub-Saharan African countries
The odds of Human immunodeficiency virus (HIV) patients with CD4 cells count < 200 were about 2 (AOR 2.023; 95% CI: 1.244, 3.290; P value 0.004) times higher among cases than in controls. is shows that lower CD4 less than 200 is statistically positively associated with occurrence of active TB in HIV patients after antiretroviral treatment (ART) initiation. e odds of being on adherence level of fair/poor were 19 (AOR: 19.002; CI: 5.590, 64.593; P value < 0.001) times higher among cases than in controls showing that being on adherence level of fair or poor was significantly associated with development of active tuberculosis among HIV patients on ART
In this study having previous TB history, low haemoglobin level, low CD4 count, fair/poor adherence level to ART, and WHO clinical disease stage III/ IV were identified as significant determinants for the occurrence of active tuberculosis among people living with HIV/Acquired immune deficiency syndrome (AIDS) following ART
Summary
Tuberculosis is a major public health concern globally, especially in sub-Saharan African countries It is the most common opportunistic infection and leading cause of mortality among people living with human immunodeficiency virus despite increased deliverance of antiretroviral therapy. Is study identified that patient’s previous TB history (AOR = 2.41; 95% CI: 1.49, 3.90; P value
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