Geleto Ayele, Abate Degu, Egata Gudina
School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.
Department of Medical Laboratory Technology, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.
Int J Health Sci (Qassim). 2017 Jan-Mar;11(1):1-8.
Globally, the number of people living with human immunodeficiency virus (PLHIV) particularly in sub-Saharan Africa is growing. This has been resulted in increased number of tuberculosis (TB) new cases. To control burden of TB among PLHIV, a number of collaborative TB/HIV activities were recommended. However, data about collaborative TB/HIV services in the study area is scarce. The objective of this study is to assess intensified TB case finding, implementation of isoniazid preventive therapy (IPT) and associated factors among PLHIV.
A facility based cross-sectional study design was employed among 419 randomly selected PLHIV from public health facilities of Harari region. Systematic sampling method was used to obtain sample from each health facilities. Interviewer-administered questionnaire was used to collect data. Data were entered into EpiData and analyzed by SPSS statistical software. Multivariate logistic regression analysis was conducted to determine the presence of association between variables using odds ratio with 95% confidence interval and association was declared significant at P ≤ 0.05.
One hundred fifteen (75.2%) of the respondents reported that they offered screening for TB during their HIV chronic cares and 94 (29.8%) of them were found to be positive for active TB. Female sex [AOR 2.51; 95%CI (1.52, 6.14)], educated patients [AOR 0.52; 95%CI (0.21, 0.83)], CD4 count greater than 350 cells/dl [AOR 0.62; 95%CI(0.22,0.82)], Antiretroviral Therapy (ART) initiation [AOR 0.50; 95%CI (0.35, 0.88)] and missing dose of ART [AOR 2.57; 95%CI (1.21, 5.32)] were significantly associated with TB infection. Nearly four-fifth (78.7 %) of the study participants were provided IPT.
Screening of TB among PLHIV and implementation of IPT in the region is lower when compared to the findings of other studies conducted in different parts of the country and needs to be improved through implementation of national and international guidelines.
在全球范围内，感染人类免疫缺陷病毒（PLHIV）的人数，尤其是撒哈拉以南非洲地区的感染人数正在增加。这导致结核病（TB）新病例数增多。为控制PLHIV人群中的结核病负担，人们推荐了一些结核病/艾滋病协作活动。然而，关于研究地区结核病/艾滋病协作服务的数据却很匮乏。本研究的目的是评估强化结核病病例发现、异烟肼预防性治疗（IPT）的实施情况以及PLHIV人群中的相关因素。
采用基于机构的横断面研究设计，从哈拉里地区公共卫生机构中随机抽取419名PLHIV进行研究。使用系统抽样方法从每个卫生机构获取样本。通过访谈式问卷收集数据。数据录入EpiData并使用SPSS统计软件进行分析。进行多变量逻辑回归分析，以使用比值比和95%置信区间确定变量之间的关联，并在P≤0.05时宣布关联具有统计学意义。
115名（75.2%）受访者报告称，他们在HIV慢性病护理期间提供了结核病筛查，其中94名（29.8%）被发现患有活动性结核病呈阳性。女性[AOR 2.51；95%CI（1.52，6.14）]、受过教育的患者[AOR 0.52；95%CI（0.21，0.83）]、CD4细胞计数大于350个/微升[AOR 0.62；95%CI（0.22，0.82）]、开始抗逆转录病毒治疗（ART）[AOR 0.50；95%CI（0.35，0.88）]以及漏服ART剂量[AOR 2.57；95%CI（1.21，5.32）]与结核病感染显著相关。近五分之四（78.7%）的研究参与者接受了IPT。
与在该国不同地区进行的其他研究结果相比，该地区PLHIV人群中的结核病筛查和IPT实施情况较低，需要通过实施国家和国际指南加以改善。
