Abstract:
Objective This study assessed the incidence of tuberculosis
(TB) and its predictors among adults living with HIV/AIDS in
government health facilities in north-east Ethiopia.
setting A 5-year retrospective cohort study was
conducted from May to June 2015 on 451 adult HIV/AIDSinfected
individuals who enrolled in the HIV care clinics
of
government
health facilities in north-east Ethiopia.
Participants
A
total of 451 HIV
-infected
adults who newly
enrolled
in the adult HIV care clinic
from 1 July 2010 with
complete
information
were followed
until May 2015.
Primary
outcome measure
The primary outcome was
the proportion of patients diagnosed with TB or the TB
incidence rate.
s
econdary outcome measure
The incidence of
TB was
investigated in relation to years of follow-up.
r
esults
A total of 451 charts with complete informa
tion
were followed for 1377.41 person-years (PY) of
observation. The overall incidence density of TB was 8.6
per 100 PYof observation. Previous TB disease (adjusted
HR (AHR) 3.65, 95%
CI 1.97 to 6.73),
being bedridden (AHR
5.45, 95%
CI 1.16 to 25.49), being underweight (body
mass index (BMI) <18.5
kg/m
2
) (AHR 2.53, 95 % CI 1.27
to 5.05), taking isoniazid preventive therapy (IPT) (AHR
0.14, 95% CI 0.05 to 0.39), haemoglobin below 11 g/dL
(AHR 2.31,
95%
CI 1.35 to 3.93),
and being in WHO clinical
stages III and IV (AHR 2.84, 95% CI 1.11 to 7.27; AHR 3.07,
95%
CI 1.08 to 8.75,
respectively) were significant for the
incidence of TB.
Conclusion The incidence of TB among adults living with HIV/
AIDS in the first 3 years of follow-up was higher compared
with that of subsequent years. Previous TB disease, no IPT,
low BMI and haemoglobin level, advanced WHO clinical
stage, and bedridden condition were the determinants of
the incidence of TB. Therefore, addressing the significant
predictors and improving TB/HIV collaborative activities should
be strengthened in the study setting.
