Magnitude and Associated Factors of Pulmonary Tuberculosis Among HIV/AIDS Patients Attending Antiretroviral Therapy Clinic at Debre Tabor Specialized Hospital, Northwest Ethiopia, 2019

Prevalence of pulmonary tuberculosis and associated factors among adults living with HIV/AIDS in Ethiopia, systematic review and meta-analysis

BACKGROUND

Tuberculosis (TB), caused by Mycobacterium tuberculosis (MTB), remains a global health crisis, especially in sub-Saharan Africa, where high human immune virus (HIV) prevalence exacerbates the problem. The co-infection of TB and HIV creates a deadly combination, increasing susceptibility and complicating disease progression and treatment. Ethiopia, classified as a high-burden country, faces significant challenges despite efforts to reduce co-infection rates. The rise of multidrug-resistant TB further complicates diagnosis and management, highlighting the urgent need for intensified efforts to combat this dual epidemic.

METHODS

Studies searched through the search engine of Cochrane Library, PubMed, Web of Science, Google Scholar. Data from included studies was extracted, organized in Excel, and then analyzed using STATA 17. The overall effect across all studies was calculated using a random-effect model. Potential publication bias and heterogeneity in the results between studies were assessed using Egger's test, forest plot, and I² statistic, respectively.

RESULTS

According to this systematic review and meta-analysis, the overall prevalence of pulmonary tuberculosis(PTB) among adults living with human immune virus /aquered immune deficieciency syndrome(HIV/AIDS) in Ethiopia was 15% (95% CI: 8-23%). Several factors were independently associated with pulmonary tuberculosis, including CD4 count below 200 cells/mm³ (OR = 4.491, 95% CI: 1.0001-8.132), WHO clinical stage III (OR = 4.487, 95% CI: 2.264-6.710)), WHO clinical stage IV (OR = 6.905, 95% CI: 5.239-8.571), smokers (AOR = 3.749, 95% CI: 2.626-5.271), ambulatory adults (AOR = 1.887, 95% CI: 1.439-2.335).

CONCLUSION

This systematic review and meta-analysis found a significant 15% pooled prevalence of pulmonary tuberculosis (PTB) among adults living with HIV/AIDS in Ethiopia. The prevalence was notably higher in individuals with lower CD4 counts, advanced HIV stages (III and IV), and in smokers. These findings underscore the need for early detection, targeted interventions, and integrated TB control programs with HIV care to mitigate the burden of PTB in this population.

Opportunistic infections among people living with HIV/AIDS attending antiretroviral therapy clinics in Gedeo Zone, Southern Ethiopia

INTRODUCTION

Opportunistic infections (OIs) are more common and severe among people with suppressed immunity like those living with HIV/AIDS (PLWH). This study aimed to assess the prevalence of OIs and associated factors among PLWH attending antiretroviral therapy (ART) clinics in the Gedeo zone, Southern Ethiopia.

METHODS

A facility based retrospective cohort study was conducted from April to June 2018 among PLWH attending ART clinics in Gedeo zone, Ethiopia from November 2016 - November 2017. A simple random sampling method was used to select the both paper based and electronic study participants' charts. Adjusted odds ratios were calculated using multivariable logistic regression analysis for variables statistically significant at 95% confidence interval under bivariable logistic regression analysis, and significance was declared at P < 0.05.

RESULTS

a total of 266 PLWH attended the selected ART clinics of Gedeo zone during the one year period were participated in the current study. The majority 104(39.1%) were within the age group 30-39, 106(60.2%) male, 184(69.2%) married, and 167(62.9%) urban residents. The study revealed the prevalence of OIs was 113(42.5%) with oral candidiasis 28(24.5%) the most prevalent followed by pulmonary tuberculosis 22(19.5%) and herpes zoster 15(13.4%). Further, study participants with ambulatory [AOR = 2.40(95% CI: 1.14, 5.03)], and bedridden [AOR = 3.27(95% CI:1.64, 6.52)] working functional status; with lower CD4 count: less than 200cells/mm3 [AOR = 9.14(95% CI: 2.75, 30.39)], 200-350cells/mm3 [AOR = 9.45(95% CI: 2.70,33.06)], 351-500cells/mm3 [AOR = 5.76(95% CI: 1.71, 19.39)]; being poor in ART adherence level [AOR = 10.05(95% CI: 4.31,23.46)]; being in stage III/IV WHO clinical stage of HIV/AIDS [AOR = 2.72(95% CI: 1.42, 5.20)]; and being chewing khat [AOR = 2.84(95% CI: 1.21, 6.65)] were found positively predicting the occurrence of OIs.

CONCLUSION

This study speckled a high prevalence of OIs with several predicting factors. Therefore, the study acmes there should be interventional means which tackles the higher prevalence of OIs with focus to the predicting factors like lower CD4 count level, less/bedridden working functional status, poor ART adherence level, advanced stage of HIV/AIDS stage and chewing khat.

Prevalence of pulmonary tuberculosis and associated factors among adults living with HIV/AIDS attending public hospitals in Shashamene Town, Oromia Region, South Ethiopia

Objective:

This study was aimed to assess the prevalence of pulmonary tuberculosis and its associated factors among adults living with HIV/AIDS attending Public Hospitals, Shashamene Town, Oromia Region, South Ethiopia.

Methods:

A cross-sectional study was conducted from November 2020 to February 2021 among Adults Living with HIV/AIDS attending Public Hospitals in Shashamene Town, Oromia Region, South Ethiopia. A sputum sample was collected and analyzed using Xpert MTB/RIF assay and blood sample was collected to count CD4 using BD FACSPresto analyzer. Semi-structured questionnaires were used to collect data. SPSS version 25 software was used for statistical analysis and a p value of <0.05 was considered as statistically significant.

Results:

In this study, the overall prevalence of pulmonary tuberculosis among adults living with HIV/AIDS attending the Public Hospitals was 23.5% (5% confidence interval: 18.26, 29.13). Variables such as age range of 50–64 years, female gender, occupation with house wife, and World Health Organization stage (III and IV) were significantly associated with prevalence of tuberculosis infection.

Conclusion:

The prevalence of tuberculosis in our study site was high. There is a need for regular screening of people living with HIV/AIDS for TB using highly sensitive method like Xpert MTB/RIF assay to know their TB status as well as early commencement of anti-TB.

Active TB infection and its associated factors among HIV-1 infected patients at Jimma medical center, Southwest Ethiopia

Background

Human immune deficiency virus (HIV) increases the susceptibility to primary infection or reinfection and the risk of tuberculosis (TB) reactivation for patients with latent TB. There was no current report on the rate of active TB infection among HIV-1 infected patients in our teaching and referral hospital. Therefore, this study was aimed to determine the prevalence and factors associated with active TB infection among HIV-1 infected patients.

Methods

Hospital-based retrospective cross-sectional study was conducted at the Anti-Retroviral Therapy (ART) chronic follow-up clinic. Systematic random sampling was used to include the patients. A structured questionnaire was used to collect data. Data were analyzed using SPSS version 25. Descriptive statistics were used to describe the findings and multivariate logistic regression was performed to identify factors associated with active TB infection.

Result

150 HIV-1 infected patients (female 54.7%) were included. The median (interquartile range, IQR) age of the patients was 33.5 (25.7, 40.0) years. Twenty-six (17.3%) of the patients had developed active TB infection, which was independently associated with the WHO clinical stage III and IV (AOR: 9.67, 95% confidence interval (CI); 2.21–42.37), p = 0.003). The use of isoniazid preventive therapy (IPT) (AOR: 0.123, 95CI; 0.034–0.44, p = 0.001) and having good adherence to ART medications (AOR: 0.076, 95CI; 0.007–0.80, p = 0.032) was associated with the reduced risk of active TB infection among HIV-1 infected patients.

Conclusions

Advanced WHO clinical stages increased the risk of active TB infection, while the use of IPT and good adherence to ART medications reduced the risk of active TB infection. Therefore, patients with advanced WHO clinical stage should be screened for TB infection, and starting IPT for the candidate patients should be strengthened to reduce the burden of active TB incidence. ART medication adherence should also be supported.