Abstract:
Background: Worldwide, TB is one of the top 10 causes of death. TB has become the number
one cause of mortality among people living with HIV. Ethiopia is one of the 22 high burden
countries and TB remains one of the leading causes of mortality. In recent years, great efforts
have been made to integrate TB treatment into HIV care. This has created the need for additional
research for better understanding of predictors of TB with the incidence of tuberculosis.
Objective: This study assessed the incidence of Tuberculosis and its predictors among
antiretroviral therapy initiated adult clients in Wolaita Sodo Otona teaching referral hospital,
Wolaita Sodo, Southern Ethiopia, 2019.
Methods:Hospital-based retrospective cohort study was conducted from March01-20/2019.From
the client record, 492 cards were reviewed using a structured data abstraction form. Four
antiretroviral therapy trained nurses were used to abstract the data. The extracted data was coded
and entered to Epi data and exported to stata version 14 software for analysis. Crude and
adjusted hazards ratios from bivariate and multivariable Cox proportional regression, 95%
confidence intervals and p-value of less than 0.05 were used to measure association to determine
predictors and as well for interpretation.
Results: During the follow-up period, 70 new tuberculosis cases were observed. Incidence rate
among unexposed working functional status is 1.52/100 PY. Incidence among exposed functional
status of ambulatory or bedridden is 8.42/100 PY. In multivariable Cox proportional hazards
regression model clients with no past history of TB (AHR=0.41, 95%CI (0.20, 0.87)) and having
BMI >=18.5(AHR=0.34 95%CI (0.18, 0.66) were found to be protective predictors. Having poor
adherence (AHR=14.70, 95%CI (6.89, 31.38)) and fair adherence level(AHR=4.60, 95%CI
(2.15, 9.82)), functional status of ambulatory or bedridden(AHR=3.52,95%CI(1.82,6.80)), and
WHO clinical stage of 3&4(AHR=3.05,95%CI(1.17,7.98)) were found to be risk predictors of
incidence TB among ART initiated adult clients.
Conclusion: The overall incidence of TB was higher in the functional status of ambulatory or
bedridden than that of the functional status of the working group. Therefore more emphasis
should be given to clients with the functional status of ambulatory or bedridden during the first
year of initiation of ART in the study area.
