Determinants of Active Tuberculosis among HIV-Positive Adults Attending Clinical Care in Ambo general hospital and Gedo hospital, West Shoa Zone, Oromia, Ethiopia (unmatched case-controlstudy)

Abstract

Background: Diseases and conditions that weaken immunity, such as malnutrition, smoking, alcoholism, HIV/AIDS and diabetes, are factors that facilitate the development of active TB disease. The rapid growth of the HIV pandemic in many developing countries has resulted in an equally dramatic rise in the estimated number of new TB cases. The Objective of this study was to assess the determinants of active TB among HIV-positive adults attending clinical cares in Ambo general and Gedo hospitals, West Shoa zone. Methods and materials: A facility based unmatched case control study design was employed using Systematic Random Sampling method from May to August/ 2015. A total sample size of 123 TB/HIV co-infected patients from Cases and 246 HIV infected without TB infection patients from control groups were selected for the study. Data were entered to computer by Epi data version 3.2.1 and transferred to SPSS version 16 software package for analysis. To measure the strength of association between dependent and independent variables, odds ratio with a 95% confidence interval was done. Finally, logistic regression was done to control possible confounders and to identify independent predictors of active TB among HIV positive patients. Results: Active TB among HIV-positive adults was significantly associated with lack of formal educational (AOR 3.23, 95%CI 1.60, 6.81), under nourished (lower BMI <18.5) (AOR 2.62, 95%CI 1.23, 5.95), advanced WHO clinical stages (AOR 2.89, 95%CI 1.12, 4.96) and CD4+count<200/µL (AOR 2.5 95%CI 1.18, 4.97) and being married is the protective factor (AOR .20 95%CI 0.11, 0.50)

Conclusion and Recommendation: lack of formal education, under nourished, advanced WHO clinical stages and CD4+ count <200/ µL were the independent predictors for active TB among HIV positive patients. People with TB/HIV co-infection are important targets for interventions such as early diagnose and treatment of opportunistic infection and giving  health education to prevent and control it.