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. 2013 Jun 28:13:292.
doi: 10.1186/1471-2334-13-292.

Incidence and predictors of tuberculosis among adult people living with human immunodeficiency virus at the University of Gondar Referral Hospital, Northwest Ethiopia

Kefyalew Addis Alene  1 , Ansha Nega, Belaynew Wasie Taye
Affiliations

Incidence and predictors of tuberculosis among adult people living with human immunodeficiency virus at the University of Gondar Referral Hospital, Northwest Ethiopia

Kefyalew Addis Alene et al. BMC Infect Dis. .

Abstract

Background: Tuberculosis (TB) is the leading killer of people living with HIV (PLHIV). Many of these deaths occur in developing countries. This study aimed at determining the incidence and predictors of tuberculosis among PLHIV.

Methods: A five year retrospective follow up study was conducted among adult PLHIV. The Cox proportional hazards model was used to identify predictors.

Results: A total of 470 patients were followed and produced 1724.13 Person-Years (PY) of observation, and 136 new TB cases occurred during the follow up period. The overall incidence density of TB was 7.88 per 100 PY. It was high (95.9/100PY) in the first year of enrolment. The cumulative proportion of TB- free survivals was 79% and 67% at the end of the first and fifth years, respectively. Baseline WHO clinical stage III (AHR = 2.88, 95% CI = 1.53-5.43), WHO clinical stage IV (AHR = 3.82, 95% CI = 1.86-7.85), CD4 count <50 cell/ul (AHR = 2.13, 95% CI = 1.28-3.53) and ambulatory or bed ridden functional status (AHR = 1.64, 95%CI = 1.13-2.38) were predictors of time to TB occurrence.

Conclusions: TB incidence rate among PLHIV, especially in the first year of enrollment was high. Advanced WHO clinical stage, limited functional status, and low CD4 count (<50 cell cell/ul) were found to be the independent predictors of TB occurrence. Early care seeking and initiation of HAART to improve the CD4 count and functional status are important to reduce the risk of TB infection.

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Figures

Figure 1
Figure 1
Kaplan-Meier curve of TB survival proportion for PLHIV on Chronic HIV care at the University of Gondar Referral Hospital, September 2006 to February, 2012.
Figure 2
Figure 2
Kaplan-Meier survival curve of TB-free proportion based on WHO Clinical Stage among PLHIV on chronic HIV care at University of Gondar Referral Hospital, September 2006 to February, 2012.
Figure 3
Figure 3
Kaplan-Meier curve of Tuberculosis -free survival proportion based on baseline CD4 cell count at enrolment at the University of Gondar Referral Hospital from September 2006 to February, 2012.
See this image and copyright information in PMC

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