PREVALENCE AND TRENDS OF MYCOBACTERIUM TUBERCULOSIS AND ASSOCIATED RISK FACTORS AMONG HIVSEROPOSITIVE PATIENTS VISITING KARAMARA GENERAL HOSPITAL, JIGJIGA TOWN, SOMALI REGIONAL STATE, ETHIOPIA

Abstract

The morbidity and mortality from Tuberculosis (TB) are still predominant among HIV infected patients in Ethiopia. Thus, institution-based cross-sectional and retrospective study designs were used to assess the prevalence of TB and associated factors among HIV sero-positive study participants at Karamara General Hospital, Jigjiga town, from September to December 2017. A total of 422 HIV-seropositive participants were systematically selected for cross-sectional study whereas data of all HIV-seropositive cases registered at the hospital between 2006/7 and 2015/16 were reviewed for retrospective study. Socio-demographic and related information was collected using pretested questionnaire. Ziehl-Neelsen staining method was employed to examine the presence of acid fast bacilli. The overall prevalence of TB in the present study was 6.6% and infection rate was higher among males (7.9%) and adult age groups (7.2%). TB infection was significantly associated (P<0.05) with occupation, alcohol abuse, khat chewing and tobacco consumption, irregular ART care, awareness on TB transmission, signs and symptoms as well as curable way. HIV positive farmers, drinkers, chewers, smokers and those with irregular ART care were 4.8, 6.4, 4.1, 14.2 and 3.7 times more likely to get active tuberculosis than their counter groups. Of 3124 HIV cases recorded in the past ten years, 845 (27.0%) were TB co-infected while its rate was comparable in males (28.6%) and females (26.0%). Trends of TB co-infection rate in karamara hospital was rising until 2008/9 but showed a decline thereafter. Its rate rose sharply 316 (72.6%) in 2008/9, and dropped sharply 52 (15.8%) in 2010/11, after which a quite steady decline was seen. Of the total pulmonary TB (PTB) cases, majority (46.9%) were smearing positive pulmonary TB. Higher number of smear negative (191) and extra pulmonary TB (39) cases were recorded in the year 2008/09 while maximum smear positive pulmonary TB cases (89) were recorded in the year 2009/10. Overall, TB infection rate is modest among persons living with HIV. However, a recent trend revealed slight rise of co-infected cases. Thus, improved TB/HIV collaboration activity and scale up of health care services is underscored to reduce risk of TB