INCIDENCE OF TUBERCULOSIS AND ITS PREDICTORS AMONG ART INITIATED ADULT CLIENTS IN WOLAITA SODO UNIVERSITY OTONA TEACHING REFERRAL HOSPITAL, WOLAITA SODO, ETHIOPIA

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.