Incidence And Predictors Of Tuberculosis Among Hiv Positive Adults In West Shoa Zone Public Hospitals, Oromia, Ethioipia, 2024

Abstract

Background: Tuberculosis is a serious health threat & leading cause of death among people with human immunodeficiency virus. In Ethiopia, although the incidence of Tuberculosis has improved due to different interventions, it remains the major cause of death among people living with human immunodeficiency virus. Objective: the main objective of this study is to assess the Incidence and Predictors of Tuberculosis among HIV Positive adults in West Shewa Zone Public Hospitals, Oromia, Ethiopia, 2024 Method: Five years Hospital-based retrospective cohort study was conducted in West Shewa zone public hospitals. Data gathered from 562 randomly selected adult HIV positive clients’ records by structured data extraction form. The data were cleaned and entered into Epi-data version 3.1 and exported to Statistical Package for Social Sciences (SPSS) Version-26 for further statistical analysis. Bivariate and multivariate Cox proportional hazards models was used to identify predictors and calculate 100 person years to determine Incidence rate of TB. Cumulative survival estimated and compared with Kaplan-Meier and log-rank test respectively. Result: Out of 562 patient records, 62 new Tb cases were observed making incidence rate to be 4.1 per 100 person year’s observation. Family size between 4 to 6 AOR: 13.002, 95%CI (1.365, 123.80), CD4 count less than 350 AOR: 3.591, 95%CI (1.416, 9.174), WHO clinical stage III AOR: 19.230, 95%CI (4.366, 83.33), hemoglobin level less than 10 gm/dl AOR: 2.439, 95%CI (1.007, 5.917), incompletion of TPT AOR: 5.395, 95% CI (1.048, 27.783) and history of LTFU AOR: 13.513, 95% CI (4.517, 40.428) were independent predictors of TB occurrence. Conclusion and recommendation: In this study, the incidence of tuberculosis is slightly low compared to the WHO estimation of 2019. Educational status of secondary education, married marital status, family size 4-6, low CD4 cell count, WHO clinical Stage III, Low Baseline Hemoglobin not completing TPT and history of LTFU were found to be independent predictors of TB incidence. Therefore, strengthening the strategies for prevention and control of TB and Close monitoring for HIV patients enrolled with Advanced WHO clinical stage, low CD4 and low hemoglobin results are recommended