Incidence of tuberculosis and associated factors among HIV infected people who enrolled in the pre-ART and ART clinics of East Gojjam, North West Ethiopia

Abstract

Introduction: The interaction between tuberculosis and HIV infection is complex. These diseases present formidable challenges alone and together as well as pose a major threat to the international community’s effort to achieve the health-related United Nations MDG for these infections. However, studies to understand the perspective of tuberculosis incidence among HIV infected people who enrolled in the chronic care units have been little in Ethiopia.

Objective: To determine incidence of tuberculosis and associated factors­ among chronic HIV care attendants.

Methods: A clinical-based retrospective cohort study was conducted from June to October 2012 in East Gojjam zone, Northern Ethiopia. All adults aged ≥ 15years and enrolled in the chronic care units were included in the study. Data were retrieved by using a pre-tested and structured questionnaire; then entered and cleaned using EPI info version 3.5, 2008 statistical software. SPSS window version 16.0 was also employed for descriptive and logistics regression analysis. 

Results: From a total of 964 study subjects, 39 of 482(8.1%) from the pre-ART group and 21 of 482(4.4%) from the ART group developed tuberculosis disease. Being widowed [AOR: 4.02; 95 % CI (1.22, 13.23)], low level hematocrit [AOR: 12.36; 95% CI (4.75, 32.19)], unable to take Cotrimexazole prophylaxis therapy[AOR: 5.89; 95% CI (2.37; 14.66)], below 350 cells/ml CD4 count [AOR:7.7; 95% CI (2.37; 24.93)] from the pre-ART group and being widowed [AOR: 6.68; 95 % CI (1.07; 41.66)], low level hematocrit [AOR: 5.93; 95% CI (1.45, 23.61)], unable to take Cotrimexazole prophylaxis therapy[AOR: 0.071; 95% CI (0.021, 0.242)], below 350cells/ml CD4 count [AOR: 10.05; 95% CI (1.26, 80.14)] from the ART group were some of the factors that had significant association with the incidence of tuberculosis.

Conclusions: In this study, the incidence of tuberculosis was high among pre-ART group than the ART group. Functional status, marital status, baseline hematocrit, CD4count, Cotrimexazole prophylaxis therapy and WHO clinical stage had association with the incidence of TB. Therefore, initiation of ART regardless of CD4 count, viral load or using WHO clinical stage of HIV/AIDS plays a significant role in preventing the co-infection of tuberculosis.