INCIDENCE  AND  PREDICTORS  OF  TUBERCULOSIS  AMONG  ADULT  PEOPLE  LIVING  WITH  HIV  AT  PUBLIC  HEALTH  FACILITIES  OF  HAWASSA  CITY,  SOUTH  ETHIOPIA.  RETROSPECTIVE  FOLLOW  UP  STUDY By: -
Creators: name: Henok Bekele
Publisher: name: National Academic Digital Repository of Ethiopia
Year: 2016

description: Introduction:  Tuberculosis  is  still  the  leading  causes  of  morbidity  and  mortality  of  people  living  with 
HIV (PLWHIV). Many of these deaths occur in developing countries,  like African. Ethiopia is one of the 
highly affected Countries by TB/HIV  co-infection  epidemics. There are few studies  done  on incidence 
and predictors TB among PLWHIV and particularly no the same study done in the study area.
Objective:  The  purpose  of  this  study  was  to  assess  the  incidence  and  predictors  of  TB  among  People 
living with HIV who were on chronic HIV care services at public health facilities of Hawassa city.
Methods:  Six  years retrospective  follow  up  study  was  conducted  among  554  adult  patient s,  who  were 
enrolled to chronic HIV care clinic from September 1, 2009 to August 31, 2010 and followed them until 
August  31,  2015.All  samples  were  taken  from  the  above  selected  enrollment  period  who  fulfilled 
inclusion criteria. The data was  entered into EPI-ENFO version 7 then exported to SPSS version 20  for 
analysis. Life table was  used to estimate TB  free  survival, the Kaplan-Meier curve (an intuitive graphical 
presentation  which  describes  survivorship  of  the  study  population)  was  used  to  estimate  the  median 
duration  of  TB  occurrence  and  log  rank  test  to  compare  TB  survival  curve  between  the  different 
categories of explanatory variables bivariate and multivariate cox proportional hazards model will used to 
identify predictors. 
Results:  Out of the 743 charts reviewed, 554  patient records were included in the analysis.  The median 
follow up period was 49.5 months [IQR=10-63 months].  The  total  follow-up period was  1830.33Person
Years (PY). A total of 161 new TB cases were observed during the follow up period. Hence,  the overall 
incidence rate of TB  was 8.79 per 100 PY. The commutative proportions of TB survival were  79%, 71% 
and  67%  at  the  end  of  one,  four  and  six  years, respectively.  Not  having  formal  education(AHR=2.68, 
95%CI: 1.41, 5.11 ), base line WHO clinical stage IV (AHR = 3.22, 95% CI=1.91-5.41), CD4 count &lt;50 
cell/ul   (AHR=2.41,  95%CI=1.31,  4.42),  ambulatory  or   bed  redden  functional  status   (AHR=  2.89, 
95%CI=1.72,  3.78),  past  TB  history  (AHR=1.65,  95%  CI  =  1.06,2.39)  substance  used  patients 
(AHR=1.46,  95%  CI=1.03,2.06)  and  enrolment  status  (being  on  pre  ART/ART)(AHR=1.62, 
95%CI:1.03-2.54 ) were independent predictors of tuberculosis occurrence.
Conclusion:  Advanced   WHO   clinical   stage  (stage  IV),   limited   functional   status,  past TB  history 
addiction and low CD4 (&lt;50cell/ul) count at enrollment were found to be the independent predictor of 
tuberculosis  occurrence.  Strengthen  the  transparency  &amp;  awareness  in  the  community  improves  early 
screening and initiation of HAART, so as to maintain CD4 count and functional status in normal range at 
the enrollment.