Institute of Public Health, Heidelberg University, Heidelberg, Germany School of Public Health, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia.
School of Public Health, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia.
BMJ Open. 2016 Apr 15;6(4):e009058. doi: 10.1136/bmjopen-2015-009058.
The objective of this study was to identify determinants for tuberculosis (TB) among HIV-infected adults in Northwest Ethiopia.
Case-control study.
Three hospitals and 10 health centres in Northwest Ethiopia.
A total of 446 individuals consented to participate in the study (150 cases and 296 controls). Cases were HIV-infected adults diagnosed with active TB, and controls were HIV-infected adults without active TB.
The link between TB and determinants was assessed using logistic regression. Determinants were categorised as sociodemographic, host-related, clinical and environmental.
Smoking (adjusted OR (AOR) 5.47; 95% CI 2.26 to 13.22), presence of a TB patient in the family (AOR 2.66; 95% CI 1.25 to 5.66), alcohol consumption (AOR 2.49; 95% CI 1.29 to 4.80) and chewing khat (AOR 2.22; 95% CI 1.11 to 4.41) were independent determinants for increased occurrence of TB. Highly active antiretroviral therapy (HAART) (AOR 0.25; 95% CI 0.13 to 0.51), isoniazid preventive therapy (IPT) (AOR 0.22; 95% CI 0.11 to 0.41) and cotrimoxazole preventive therapy (AOR 0.32; 95% CI 0.19 to 0.55) had a protective effect against TB.
HIV-infected adults with substance abuse (tobacco smoking, khat chewing and alcohol) should be prioritised for TB screening. This study reaffirmed that HAART and IPT are some of the best strategies for reducing TB occurrence in HIV-infected adults. These findings provide impetus to intensify tracing of TB household contacts.
本研究旨在确定埃塞俄比亚西北部 HIV 感染者中结核病（TB）的决定因素。
病例对照研究。
埃塞俄比亚西北部的 3 家医院和 10 家卫生中心。
共有 446 人同意参与研究（150 例病例和 296 例对照）。病例为确诊为活动性结核病的 HIV 感染者，对照为未患活动性结核病的 HIV 感染者。
采用逻辑回归评估 TB 与决定因素之间的关联。决定因素分为社会人口统计学、宿主相关、临床和环境。
吸烟（调整后的比值比（AOR）5.47；95%CI 2.26 至 13.22）、家庭中有 TB 患者（AOR 2.66；95%CI 1.25 至 5.66）、饮酒（AOR 2.49；95%CI 1.29 至 4.80）和咀嚼恰特草（AOR 2.22；95%CI 1.11 至 4.41）是结核病发生增加的独立决定因素。高效抗逆转录病毒治疗（HAART）（AOR 0.25；95%CI 0.13 至 0.51）、异烟肼预防治疗（IPT）（AOR 0.22；95%CI 0.11 至 0.41）和复方磺胺甲噁唑预防治疗（AOR 0.32；95%CI 0.19 至 0.55）对结核病具有保护作用。
应优先为有药物滥用（吸烟、咀嚼恰特草和饮酒）的 HIV 感染者进行结核病筛查。本研究再次证实，HAART 和 IPT 是减少 HIV 感染者结核病发生的最佳策略之一。这些发现为加强结核病家庭接触者的追踪提供了动力。
