NEW CASE OF TUBERCULOSIS AND ITS PREDICTORS AMONG ADULT HIV POSITIVES WHO ARE ATTENDING ART CLINICS IN HARAR AND DIRE DAWA PUBLIC HOSPITALS, EASTERN ETHIOPIA.

Abstract

Background: Tuberculosis is one of the main opportunistic infections and the leading cause of morbidity and mortality among people with Human Immunodeficiency Virus / Acquire Immune Deficiency Syndrome. This needs an adequate understanding of the situation through additional research in the study area where TB incidence rate and associated factors are not enough yet studied. This study, especially necessary in eastern Ethiopia so that, in order to reduced burden of TB among HIV positive intended to determine the magnitude of TB incidence. Objectives: Incidence of Tuberculosis and its predictors among adult HIV positives who are attending ART Clinics in Harar and Dire Dawa public hospitals, Eastern Ethiopia. Methods: A five year institution based retrospective follow up study was conducted in Harar and Dire Dawa public hospitals from January 20 - February 20, 2018. A total of 600 study (exposed to unexposed) included in the study. Data were entered onto EPI-data version 3.1 then exported to SPSS version 20 for further analysis. Bivariate and multivariate Cox proportional hazards model were used to identify predictors and calculate 100 person year to determine Incidence rate. Results: The overall active tuberculosis incidence rate on the follow up period was 7.75 cases per 100 Person-Years. Patients had clinical stage 3 and 4 (AHR= 2.11, 95% CI:1.21, 3.65) and (AHR=3.41, 95% CI:1.61, 7.23) respectively, body mass index less than <18.5 (AHR= 1.97, 95% CI:1.27, 3.05),CD4 count less than <350 (AHR= 2.01, 95% CI:1.08, 3.70), non-use of isoniazid preventive therapy (AHR= 1.98 , 95% CI:1.25, 3.14) and poor adherence to ART (AHR= 2.42, 95% CI: 1.19, 4.89) were significantly predicted incidence of tuberculosis. Conclusion: Incidence rate of tuberculosis was high during the first year of follow up, especially on patient with advanced clinical stage, low CD4 count, low body mass index, and nonuse of isoniazid preventive therapy and poor adherence to anti-retroviral treatment. So screening of Tuberculosis is highly recommended at initiation and during follow up of treatment.