Incidence of Tuberculosis and its Predictors Among Under-Five Children with Severe Acute Malnutrition in North Shoa, Amhara Region, Ethiopia: A Retrospective Cohort Study

Abstract

Background: Although Tuberculosis (TB) is one of the major public health challenges in severely malnourished children throughout the globe, it is a particularly serious issue for countries like Ethiopia that have significant resource limitations. Despite few studies have looked at incidence of tuberculosis and its predictors among under-five children with severe acute malnutrition in developing countries, there is paucity of data still. Therefore, this study aimed to estimate incidence of tuberculosis and its predictors among under-five children with severe acute malnutrition in North Shoa, Amhara region, Ethiopia. Methods: An institution-based retrospective cohort study was conducted between January 20, 2017 to June 20, 2019. Data were collected by reviewing patients’ charts using a simple random sampling technique. Data entry was done using Epi-data version 4.2 and analyzed with STATA 14. Kaplan-Meier survival curves were computed. Cox-proportional hazard models were fitted to detect the determinants of tuberculosis. The hazard ratio with 95% confidence interval was subsequently calculated. Variables with p-values < 0.05 were considered statistically significant. Results: The incidence rate of tuberculosis among under-five children with SAM was 4.6 per 100 child months (95%CI: 7.29, 8.9). The median duration of hospital stay was 9 days (IQR 5, 12). Predictors of TB were history of contact with a known TB cases [AHR: 1.68 (95%CI: 1.11,3.12)], HIV/AIDS [AHR: 3.41 (95%CI: 1.10, 11.191)], diarrhea[AHR: 1.3 (1.07 (1.59)], pneumonia[AHR: 2.10(1.76,12)], not supplying with zinc[AHR:2.81(1.054, 4.19)], and failed appetite taste[AHR: 2.3(1.76, 3.52)]. Conclusions: In this study, the incidence rate of TB was high. Diarrhea, not supplying with zinc, failed appetite taste, history of contact with a known TB cases, HIV/AIDS and pneumonia were significant predictors of TB. Funding Statement: The authors have also confirmed that no financial funding was received for the study, authorship, and publication of this article. Declaration of Interests: The authors declare that they have no conflicts of interest. Ethics Approval Statement: Ethical clearance was obtained from institutional review board of school of graduate studies, college of health science, Wollo University. Following this, study setting (SC clinic) was informed about the objective. Since the study was conducted by taking appropriate information from medical chart, it will not inflict any harm on the patients. The name or any other identifying information was not be recorded on the checklist and all information that was taken from the chart was kept strictly confidential and in a safe place.