Incidence and predictors of tuberculosis among HIV positive children in Adama Referral hospital and medical college, East Shoa Ethiopia, 2018. a retrospective follow up study
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Date
2018-06
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Addis Ababa University
Abstract
Background: Tuberculosis is an infectious disease caused by the bacillus Mycobacterium
tuberculosis. It typically affects the lungs (pulmonary TB) but can affect other sites as well.
Tuberculosis is a common condition in HIV-infected children; however, its effect on survival
of HIV infected children after confirmed of HIV/AIDS is not well understood. There are few
or no studies done on incidence and predictors of TB among HIV positive children
particularly in the study area.
Objectives:- The aim of the study is to assess the incidence and predictors of tuberculosis
among HIV positive children in Adama referral hospital and medical college.
Methods: Five years retrospective study follow up study method was conducted using a
checklist to gather data from 428 randomly selected children's charts. The data extraction tool
was developed from the standardized ART entry and follow up form currently used by the
ART clinics. Data was cleared and entered into Epi-data version 4.2.0.0 and exported to stata
version 14.1 for further statistical analysis. Data was analyzed by bivariate and multivariate
analysis using Cox regression proportional hazard model. Survival were calculated and
compared with the Kaplan Meier and log rank test.
Result: Out of the 466 charts reviewed, 428 patient records were included in the analysis. The
total follow-up period was 1109.55 Person-Year (PY). A total of 67 new TB cases were
observed during the follow up period. Hence, the incidence rate in this cohort was found to be
6.03 per 100 child-years observation. Base line Hemoglobin level<10g/dl (AHR:7.04, 95%
CI:1.03-48.15),not taking CPT at baseline (AHR: 2.41,95% CI: 1.07, 5.45),not taking IPT
(AHR: 8.23,95% CI:2.11,32.06), not appropriately vaccinated (AHR:3.73, 95% CI:1.59,8.76)
moderate underweight (AHR:5.19, 95% CI: 1.89,14.21) and moderate wasted (AHR: 2.86,
95% CI : 1.02, 7.99) were independent predictors of TB occurrence.
Conclusion and recommendation:-Incidence of tuberculosis was high especially during the
PRE ART groups on HIV chronic care. Baseline moderate underweight and moderate
wasting, not taking prophylaxis's(CPT and IPT),inappropriate vaccination and anemia
(Hgb≤10mg/dl) found to be the independent predictor of TB occurrence among HIV positive
children. Therefore, close follow up of HIV exposed children to make early diagnosis and
treatment initiation before the development of malnutrition and anemia is important.
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Keywords
Incidence, Predictors, Tuberculosis, children, HIV/AIDS, Adama, Ethiopia.