Debre Markos Referral Hospital Research Articles

Patient Waiting Time and its Determinants in the General Outpatient of Debre Markos and Felege Hiwot Referral Hospitals Amhara Regional State, Ethiopia

Background: Patient waiting time is defined as the total time from registration until consultation with a doctor. Experiences of waiting in general are perceived as complex, subjective, and culturally influenced. Registration time, payment process/cash billing, recording classification/triaged time, few human resources and work process are the determinants of patient waiting time in the general outpatient departments. However, the complexity of wait time is poorly understood and has been explored only to a limited extent. Objective: To assess patient waiting time and its determinants in Debre Markos and Felge Hiywot Referral hospitals of Amhara Regional State in North West, Ethiopia. Methods: A hospital based comparative cross sectional study design wasemployed from October 20- November 20, 2014. The study population was patients presenting to general outpatient departments, from which464 patients was selected using systematic random sampling technique. Quantitative Data was collected using structured questionnaire and a check list adopted from studies.Quantitativedata was coded, entered, cleaned and analyzed using SPSS Software for windows version 20.0.Linear regression and bivariate logistic regression was applied to identify the determinants of each explanatory variable on outcome (patient waiting time).Finally data was interpreted by referring to the pertinent findings from the relevant literature reviewed. Ethical approval and clearance was obtained from ethical clearance committee of the Jimma University College of Public Health & Medical Sciences Result:The measured waiting time in Felge Hiywot referral hospital mean waiting time was and its standard deviation 149.2±72.1 minutes where as 94.2±58.3 minutes in debere markos referral hospital. The major causes of the long patient waiting time was large numbers of patient with a few doctors 94(40.5%),67(28.9%) ,long searching of the cards 67(28.9%),73(31.5),and long registration time 59(25.4%),76(32.5) in Feleg hywot and debre markos referral hospitals respectively. the satisfaction status in waiting time greater than 60 minutes in Felege hiywot referral hospital were statically significance with p value 0.0001(95% CI:1.7786,1.8766) with dissatisfaction whereas p= 0.0001 (95% CI;1.7690,1.8689) in debre markos referral hospital. Conclusion: There is the need for health care facilities and hospital administrators to address gaps in human resources, infrastructures and other internal procedures and institutional systems aimed at reducing waiting times and thus ensuring an effective health care.

Modern Family Planning Utilization and Associated Factors among HIV Positive Reproductive Age Women in Debre Markos Referral Hospital Northwest Ethiopia, 2014 G.C.

The study was conducted to find out modern family planning utilization and associated factor among HIV positive reproductive age women attending anti retroviral treatment care in Debremarkos referral hospital, in Ethiopia. Institution based cross-sectional study was carried out. Three hundred thirty five HIV positive reproductive age women were selected using systematic random sampling methods. Data were collected and analyzed. About 47.9% HIV positive reproductive age women are currently using modern family planning methods. Level of education has significant effect on utilization of modern family planning methods. Women with primary education and secondary education and above are utilizing modern family planning methods 2.71 times and 6.91 times more from non educated women, respectively. Number of children has also effect in utilization of modern family planning methods. Those who have one child and two and more children are utilizing modern family planning methods 5.31 and 11.66 times more than those who do not have children, respectively. Utilization of modern family planning methods was low and the most commonly used methods were condom and inject able contraceptives. In order to enhance utilization of modern family planning methods for HIV positive women, family planning services must be integrated with anti retro viral treatment care and support service sites and women’s educational status must be improved.

Common Mental Disorder among HIV Infected Individuals at Comprehensive HIV Care and Treatment Clinic of Debre Markos Referral Hospital, Ethiopia

Introduction: The presence of HIV/AIDS increases the risk of development of mental disorders and the presence mental illness affects disease progression. The resulting co morbidity complicates help -seeking, diagnosis, quality of care provided, treatment and its outcomes, and adherence. Despite the fact that developing countries carry huge burden of both HIV/AIDS and mental illness, no data about the co-occurrence/link and factors associated is available in local setting. The aim of this study was to assess the prevalence of common mental disorder and associated factors among PLHA at Comprehensive HIV Care and Treatment Clinic of Debre Markos referral Hospital in 2013/2014. An institution-based cross sectional study with the Amharic version of the SRQ was conducted. Ethical clearance was obtained from Institutional Review Board of Debre Markos University and Informed consent was obtained. Result: Mean age was 37.9 years ± 10.05 years. Prevalence of CMD is found to be 24.3%. Significant associations were found between CMD and past psychiatric illness, ART regimen, marital status, HIV/AIDS disclosure and perceived stigma. Conclusion and recommendation: There was a significant burden of mental illness among HIV-infected individuals in this setting. It is important to note that the link between HIV care and treatment services and psychiatric service should strengthen. Hospital administrators must give better attention to inpatient mental health service including substance abuse treatment. Clinicians also should always assess HIV-infected subjects for depression, anxiety and other common mental disorders to ensure early detection and treatment.

Isolation and antimicrobial susceptibility pattern of Staphylococcus aureus in patients with surgical site infection at Debre Markos Referral Hospital, Amhara Region, Ethiopia.

BackgroundStaphylococcus aureus, especially Methicillin Resistant Staphylococcus Aureus (MRSA) is a major health problem recognized as the most important nosocomial pathogen, often causing postoperative wound infections. Antibiotic resistance by MRSA has grown to be common, and resistance to almost all antibiotics has been found among these strains. The aim of this study was to determine the prevalence, antimicrobial susceptibility patterns and associated risk factors of S. aureus in patients with surgical site infections in an Ethiopian hospital.MethodsA cross-sectional study was conducted from December 1, 2011 to March 30, 2012 among patients with surgical site infections at Debre Markos Referral Hospital, Debre Markos, Ethiopia. All wound swabs obtained from patients with surgical site infections during the study period were cultured on mannitol salt agar media which is selective for S. aureus. Isolated strains of S. aureus were tested for antibiotic susceptibility patterns using standard disc diffusion technique, and interpretation of resistance was done based on Clinical and Laboratory Standard Institute criteria. Univariate and multivariable analyses were used to assess the risk factors.ResultsOf the 184 surgical patients who had developed surgical site infection, S. aureus was isolated from 73 (39.7%) cases. Out of the 73 isolates of S. aureus, 36 (49.7%) were MRSA. Among the study participants, prevalence of MRSA was found to be 19.6%. The clinical isolates showed >80% level of resistance to ampicillin, amoxicillin, penicillin G, erythromycin, gentamicin and cotrimoxazole whereas <50% level of resistance was observed against clindamycin, oxacillin, tetracycline and vancomycin. MRSA strains showed resistance ranging from 5.6% (vancomycin) to 100% (cotrimoxazole). Of the following risk factors: sex, age, pus consistency, duration of operation, type of surgery, ward and hospital stay, laparotomy type of surgery was identified as a risk factor for infection by S. aureus.ConclusionThe prevalence of S. aureus and/or MRSA infection in surgical and gynaecology & obstetrics wards of Debre Markos Referral Hospital was found to be high. The majority of isolates were highly resistant to major antimicrobial agents.

English

Globally, human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) reduces life expectancy by seven years. Mortality is high among non-treated patients in Ethiopia with about 58.1/100 person years of observation. However, the predictors of mortality have not been adequately studied. Hence, the main objective of the study was to determine predictors of mortality among HIV positive adults on antiretroviral treatment in Debremarkos Referral Hospital, Northwest Ethiopia. A facility-based retrospective cohort study design was conducted from September to February, 2013. Data were collected from 640 patients who were enrolled for treatment in Debremarkos Referral Hospital from 2005 to 2013. Proportional hazards Cox model was used to show the independent predictors of the risk of mortality. A total of 261 patients died during the follow up period. Baseline hemoglobin level of < 10 g/mm3 (Adjusted Hazard Ratio (AHR) = 1.86, 95% CI: 1.39 to 2.64), baseline ambulatory functional status (AHR = 2.72, 95% CI: 1.90 to 3.90), bedridden functional status (AHR = 2.38, 95% CI: 1.32 to 4.27), baseline World Health Organization (WHO) staging III and IV (AHR = 2.16, 95% CI: 1.10 to 4.25), recent antiretroviral therapy (ART) adherence (AHR: 2.16, 95% CI: 1.03 to 4.56) and fair adherence (AHR = 1.88, 95%CI: 1.08-3.29) were associated with increased mortality. The risk rate of patients with unexplained chronic diarrhea and without prophylaxis for tuberculosis was increased by 1.53 and 3.98 times compared to patients without diarrhea and treated with tuberculosis prophylaxis, respectively. The mortality rate was high during early phase of treatment especially within the first 6 and 12 months. Baseline hemoglobin < 10 g/mm3, baseline functional status-ambulatory and bedridden functional status, baseline WHO staging (stage III and IV), poor recent antiretroviral therapy adherence, chronic diarrhea and absence of tuberculosis prophylaxis were all significant predictors of mortality. Therefore, patients with the aforementioned predictors should be followed closely and frequently. Key words: Predictors, mortality, HIV positive adults, antiretroviral therapy, Ethiopia.

Prevalence and Associated Factors of Art Adverse Effect among PLWH on Art in Debre Markose Referal Hospital, North East Ethiopia, 2013

Antiretroviral treatments adverse effect is one of the challenges in HIV/AIDS prevention and control programs. The major objective of this study was assessment of the level of ART adverse effect and its associated factors among people living with HIV (PLWH) on ART in Debre Markos Referral Hospital from October 2 to November 30/2013. Institutional based cross-sectional quantitative type of study design was conducted to determine the level of ART adverse effect among randomly selected 373 adult PLWH on ART in Debre Markos referral hospital. The study participants were selected using systematic random sampling technique. Both primary and secondary data were gathered using a structured questionnaire. The collected data were entered, processed and analyzed in STATA V.11. The period prevalence of ART adverse effect was 51. 4%. The most common type of adverse effect was lipoathrophy (37.5%, n=72) and the least was Hepathotoxicity (0.52 %, n=1). The odds of ART adverse effect were 0. 523 times less likely among those who were literate compared to illiterate [AOR=0.477, 95% CI=0.28-0.812]. similarly, it was 0.44 times less likely among the study par-ticipants with preparatory school level of educational status compared to those with primary school [AOR=0.56, 95% CI=0.443-0.953]. The odds of ART adverse effect were 0.725 times less likely among those had a monthly income of ≥ 3551 Ethiopian Birr compared to those had no a regular monthly income [AOR=0.275,95%CI=0.098-0.773] and were 0.546 times less likely among substance non-abusers than abusers [AOR=0.454,95%CI=0.253-0.817]. The prevalence of ART adverse effect in Debre Markos referral Hospital was found. The leading adverse effect was Lipoathrophy. Factors such as educational status, income and substance abuse were identified independent determinants of ART adverse effect. The program managers, implementers and service providers need to take in to consideration the emerging need of adult education, health education and creation of income generating activities for adult PLWHs on ART in Debre Markos Referral Hospital. Furthermore it is better to disseminate information on the possible Antiretro-viral therapy adverse effects using leaflets and patient- physician regular education program.

Survival status of hiv positive adults on antiretroviral treatment in Debre Markos Referral Hospital, Northwest Ethiopia: retrospective cohort study.

Introduction: Survival is low among non-treated patients. The time to survive after ART initiation has not been adequately studied. Thus, this study was aimed to determine survival status and associated factors among HIV positive adults on antiretroviral treatment in Debre Markos Referral Hospital, Northwest Ethiopia. Methods: Facility-based retrospective cohort study design was conducted from September to February 2013. Data were collected from 640 patients' registration card in Debre Markos Referral Hospital who enrolled for treatment from 2005 to 2013. Kaplan-Meier survival curves and Log-Rank test were used to compare the survival times of different groups of patients. Results: A total of 640 patients followed for median of 58 months and 261 patients died during the follow up period. Over all estimated mean survival times of patients was 65.22 (95%CI: 61.409-69.043) months after initiation of treatment. Baseline hemoglobin <10g/mm3, (AHR=1.869, 95%CI: 1.319-2.649), baseline ambulatory functional status (AHR=2.727, 95%CI: 1.905-3.905), bedridden functional status (AHR=2.382, 95%CI: 1.326-4.279), baseline WHO staging III and IV (AHR=2.164, 95%CI: 1.101-4.258), recent ART adherence (AHR: 2.169, 95%CI: 1.030-4.567) and fair adherence (AHR=1.887, 95%CI: 1.081-3.295) were associated with survival of the patients. Conclusion: The Kaplan-Meier results showed that the general mean estimated survival time of patients after Highly Active Anti Retroviral Therapy (HAART) initiation was improved. But low baseline hemoglobin, ill-health functional status, poor ART adherence were negatively associated with lesser survival of patients.

Prevalence of Opportunistic Infections and Associated Factors among HIV Positive Patients taking Anti-Retroviral Therapy in DebreMarkos Referral Hospital, Northwest Ethiopia

Introduction: Opportunistic infections (OIs) are infections that are more frequent or more severe because of immune-suppression in HIV-infected persons, and they are the major clinical manifestation of HIV patients. They indirectly affect the natural history of HIV disease. Many studies concentrated on drug adherence, survival and other aspects of the diseases but limited studies are evident on OIs after Anti-Retroviral Therapy (ART) initiated. So this study was conducted to assess the prevalence of opportunistic infections and associated factors among HIV positive patients taking (ART) in DebreMarkos referral hospital, Northwest Ethiopia. Methods:A cross sectional study design was conducted among HIV patients taking ART from 5 to 7years. The study was conducted in DebreMarkos referral hospital among 423 patients. The data was entered in EPI data version 3.1 and analysis with done by using Statistical Package for Social Sciences (SPSS) version 16.0. Bivariate and multivariate analysis was performed to determine the association of each independent variable with occurrence of OIs. 95% CI and p-value less than 0.05 were considered as significant association. Result: Majority, 241(57%) of the study participants were female patients. The mean age of the study participants was 35.17, with standard deviation of +/- 9.481 years. A total of 181 OIs were observed from the study participants during the study period. The commonest type of OIs were oral candidiasis 50(11.8%), followed by chronic diarrhea for greater than 1 month, 42(9.9%) and tuberculosis, 41(9.7%). The factors associated with OIs were; Age less than 40 years old was protective (AOR=0.47, 95%CI=0.25, 0.90); baseline WHO stages of IIII those who used to chew khat was at risk of developing OI almost five times more likely than those who did not chew (AOR=4.733, 95%CI=1.185, 18.915); patients with good ART adherence were less likely to develop OI compare to their counter parts (AOR=0.163, 95%CI=0.051, 0.522); current hemoglobin level of ≥ 10 g/dl was protective (AOR=0.313, 95%CI=0.162, 0.605); and recent weight of <60 kg (AOR=3.658, 95%CI=1.656, 8.078). Conclusion and recommendation: The prevalence of OIs among HIV patients on ART is still high namely oral candidiasis, pathogens that cause chronic diarrhea and tuberculosis. Education on adherence of medications, and use of prophylactic medications for OIs should be given for HIV patients taking ART. Similar studies should be conducted to identify the relation between substance abuse and OIs in HIV patients taking ART

Factors Associated with Macrosomia among Neonates Delivered at Debre Markos Referral Hospital, Northwest Ethiopia, 2014: A Case Control Study

Introduction: Macrosomia is defined as birth weight of 4,000 gm and above irrespective of gestational age and affects 3-15% of all pregnancies. Multiple factors are related with fetal macrosomia. The factors associated with macrosomia in Debre Markos Referral Hospital were not well known. Objective: The main aim of this study was to assess factors associated with macrosomia in Debre Markos Referral Hospital Northwest Ethiopia, 2014. Methods: An institutional based unmatched case control study design was conducted. A total of 338 macrosomic neonates whose weight is >=4000 gm were selected for Cases and 676 normal birth weight neonates whose weight is between 2,500–3,999 gm were selected for the controls using simple random sampling technique. Data were collected from the medical records using data collection checklist. The collected data were entered into Epi data version 3.1 computer programs and exported to SPSS version 20 for analysis. Prior to the analysis, the whole data were cleaned; compiled and analyzed using SPSS version 20. Binary logistic regression was used to identify the factors associated with macrosomia. The results of the study were presented by text and tables based on the types of data. Results: Neonates born from multiparus women were 1.44 times more likely to have macrosomia as compared to neonates born from primiparus women with 95%CI of AOR (1.05, 1.98). Neonates born post term were 3.67 time more likely to have macrosomia as compared to preterm deliveries with 95% CI of AOR (1.01, 13.32). Maternal complications were significantly associated with neonatal birth weight with (Linear by linear X2 value = 35.9, p- value 0.000). Conclusion: Multiparty and post maturity were predictors of macrosomia. Maternal complication were common in macrosomic groups and hence preventing multi parity and post maturity decrease the incidence of macrosomia and its maternal complication.

Assessment of Maternal Near Miss at Debre Markos Referral Hospital, Northwest Ethiopia: Five Years Experience

Maternal mortality in Ethiopia is one of the highest in the world. Data on maternal near miss cases and events among mothers who received care at health institutions is lacking. The main aim of this study was, therefore, to assess trend and correlates of maternal near miss case at a referral hospital. Case notes of clients who received care in obstetric and gynecologic ward of Debre Markos Referral Hospital from 1st January 2008 to 30th December 2012 were reviewed. Case notes were selected using systematic random sampling technique. Tailored format was data collection tool. SPSS version 16 was used to analyze the data. Logistic regression was fitted to determine possible association, and strength of associations was measured using odds ratio at 95% confidence interval. A total of 1355 case notes were reviewed. Of them, 403 (29.7%) were near miss cases. The data showed that maternal near miss ratio over the study period was decreasing (X2 = 7.4, p = 0.007). Distance from the hospital, history of difficult labor, and antenatal care (ANC) utilization were found to be major determinates of maternal near miss cases. The most common types of near miss events were obstructed labor and hemorrhage. Majority of maternal near miss cases brought referral letter to hospital. Although maternal near miss ratio is still high, it appears to decrease over the last five years period. This may reflect success of the government’s Endeavour to decrease maternal mortality. However, this effort needs to continue in a sustainable manner to avoid preventable causes of maternal mortality in Ethiopia.

Level of ART Adherence and Associated Factors among HIV Sero- Positive Adult on Highly Active Antiretroviral Therapy in Debre Markos Referral Hospital, Northwest Ethiopia

Background: The current number of sero-positive HIV patients in Ethiopia is about 700,000 with overall estimated prevalence of 1.5%. The introduction of combination ART including protease inhibitors has resulted in striking reductions in HIV-related mortality. Numerous reports have documented that the key to the success of the new HAART is the ability and willingness of HIV-positive individuals to adhere to complex ART regimens, and at least 95% adherence is required for ART regimens to be fully effective. Objectives: The main aim of this study was to assess level of adherence to ART and associated factors among HIV sero-positive adult on HAART. Methods: An institutional based cross-sectional study was conducted on 377 participants selected by systematic sampling technique. A pre-tasted structured questionnaire was used by employing interview to collect necessary data. The collected data were analyzed using SPSS 16.0 version. Significance level was set at 95% CI and p-value of <0.05. Results: The adherence rate of the study participants was 88.6%. Monthly family income [(AOR 0.3, 95%CI 0.13, 0.69)], delayed in taking ART drugs AIDS [(AOR 0.6, 95% CI 0.16,0.88)], fitness of daily treatment schedule [(AOR 9.7, 95% CI 4.6,28)] and consistently taking of ART drugs [(AOR 5.7,95%CI, 2.6,25.3)] were significantly associated with ART adherence. Conclusion: The ART adherence level in this study was low. Delay in taking ART drug AIDs, monthly family income, fitness of daily treatment schedule and consistent taking of ART drugs were significantly associated with ART adherence. Measures have to be taken to address these problems.

HIV Dementia among HIV Positive People at Debre Markos Hospital, Northwest Ethiopia

Background: HIV dementia which impairs life by causing learning, memory, behavioral and motor disabilities is still a particular problem in the HAART era. It has been prevalent particularly in the third world and specifically in sub Saharan Africa where limited access to diagnosis, treatment, care and support has been common. Hence the assessment of HIV dementia in one of the sub Saharan countries, namely Ethiopia, particularly in Debre markos referral hospital is important. Methods: A cross- sectional study design with descriptive and analytical components was employed on 423 participants with systematic random sampling technique (with proportional allocation). Data was collected by face to face interview, observation and document review using International HIV dementia scale translated into local language (Amharic version); then it was analyzed using SPSS window 20. The level of association was dealt using confidence interval and odds ratio. Result: the prevalence of HIV dementia was 24.8%. Having no education (AOR=3.11, 95% CI (1.37, 7.04)), older age of 50 years or above (AOR=4.25, 95% CI (1.05, 17.18)), having co morbid opportunistic infection (AOR=7.48, 95% CI (4.1, 13.64)) and substance use (AOR=4.64, 95% CI (2.3, 9.36)) were significantly associated with HIV dementia. Conclusion: Despite wide spread use of HAART, HIV dementia among HIV positive people is high when compared to worldwide figure. Having no education, older age of 50 years or more, being on HAART, having co morbid opportunistic infection, being in late stages of the illness and substance use were significantly associated with HIV dementia. Recommendation: starting HAART in those who developed opportunistic infection and in those 50 years or older PLHA should be considered regardless of the CD4 count.

The Implementation of Nursing Process and Associated Factors among Nurses Working in Debremarkos and Finoteselam Hospitals, Northwest Ethiopia, 2013

Background: The aim of this study was to describe the level of implementation of nursing process and associated factors among nurses working in DebreMarkos Referral Hospital and Finote Selam District Hospital, northwest Ethiopia, 2013. Materials and methods: A total of 124 nurses with one year and above working experience in the respective hospitals gave complete response out of 139 total nurses. Self-administered questionnaire from standardized and pre-tested tool were adopted to collect data. The data was entered using Epidata version3.1 and analyzed using SPSS software. In addition to descriptive statistics both bivariate and multivariate logistic regression model fitted to identify possible factors associated with nursing process implementation. Then those variables with P-value of <0.05 at 95% confidence interval (CI) was declared as statistically significant. Results: Among 124 total respondents 72 (58.2%) were female nurses, the ages of the respondents were between 20 and 62 years with median age of 29 years. They implemented nursing process at various degree of consistency 46 (37.1%) practice it very much, 62 (50%) practiced somewhat and the rest 16 (12.9%) not at all and not really practiced. Low knowledge negatively associate with nursing process implementation, Adjusted odds Ratio (AOR) 0.16, at 95% CI=0.07-0.39) and Presence of patients with uncomplicated case facilitate nursing process implementation (AOR=5.67, at 95% CI=2.52-12.73). Conclusion: The level of nursing process implementation is low among nurses. Factors associated with implementation of nursing process among nurses working in hospitals were; presence of patients with complicated case and low level of knowledge about nursing process. Nurses’ patient care knowledge in general and

Survival and Predictors of Mortality among Adult Patients on Highly Active Antiretroviral Therapy at Debre-Markos Referral Hospital, North West Ethiopia; A Retrospective Cohort Study

Background: The number of annual acquired immune deficiency syndrome (AIDS)-related deaths worldwide is steadily decreasing. In resource-poor settings, like Ethiopia the treatment was started recently. The survival and factors contributing to mortality are not yet well established. Objective: To analyze the survival and predictors of mortality among adult patients started highly active antiretroviral treatment from September, 2005 to August, 2010 at Debre Markos Hospital, Ethiopia. Methods: This was a retrospective cohort study among 930 adults who started HAART between September 2005 and August 2010 at Debre-Markos Hospital. Data was extracted from paper based medical records data base and the survival of patients was estimated by Kaplan-Meier Predictors of mortality were identified by Cox proportional hazards models. Results: The survival patients were 57.0% (95% CI [53-60] at 72 months. The significant predictors of mortality were advanced WHO stage (AHR=1.6, 95% CI [1.118-2.371]), mild anemia (AHR=2.6, 95% CI [1.886-3.640]), moderate to severe anemia (AHR=4.3, 95% CI [2.998-6.131]), poor adherence (AHR=3.1, 95% CI [2.341-4.129]), CD4 50-99 cells/l (AHR=2.0, 95% CI [1.058-3.889]) , CD4<50 cells/l (AHR=2.2, 95% CI [1.140-4.182]) and not taking cotrimoxazole prophylaxis (AHR=1.7, 95% CI [1.272-2.172]). Conclusion: The study has shown an overall high mortality. The advanced WHO stage, anemia, not taking cotrimoxazole prophylaxis, poor adherence and low CD4 cell count plays an important role in the mortality of patients. A careful monitoring of patients particularly during the first 3 months of HAART is necessary.

Tuberculosis and Human Immune Deficiency Virus Co-infection in Debre Markos Referral Hospital in Northwest Ethiopia: A Five Years Retrospective Study

Background: Tuberculosis (TB) and Human Immunodeficiency Virus (HIV) are major public health problems, especially in Sub-Saharan Africa including Ethiopia. So, updated information on TB-HIV co-infection might be important for the planning, resource allocation, prevention and control activities. Objective: To determine the TB-HIV co-infection and possible associated factors among patients attended TB clinic in five years (2008-2013) at a referral Hospital in Northwest Ethiopia. Methods: A retrospective study was conducted among 717 TB patients who are registered at DOTs clinic of Debre Markos referral hospital. Socio-demographic and clinical data of the study participants were collected from the TB log from the DOTS clinic. Data were entered and analyzed using SPSS version 16 software. Results: The prevalence of TB-HIV co-infection was 44% (321/717). The trend of co-infection was decreased from 2008/9 179 (49.2%) to 2012/13 29 (44.6%). Types of TB and age group were significantly associated with TB-HIV co-infection. Conclusion: The prevalence of TB-HIV co-infection was high. Therefore, actions targeting (health education and early case detection) on those predictors are necessary to effectively reduce TB-HIV co-infection and strengthen the collaborative activities.