Aboma Mecha, Abdisa Bayisa, Imana Gudata, Taye Kefyalew, Moti Gonfa, Fufa Merob
College of Health Science and Referral Hospital Ambo University, Ambo, Ethiopia.
PLoS One. 2025 Mar 10;20(3):e0319676. doi: 10.1371/journal.pone.0319676. eCollection 2025.
TB is the most frequent opportunistic infection and cause of death among People living with HIV/AIDS. Human immunodeficiency virus-positive individuals are routinely screened for tuberculosis as a means of monitoring efforts to mitigate the consequences of the disease on HIV-positive patients. TB status assessment identifies HIV-positive clients who show no evidence of active TB by symptom screening and would benefit from treatment with isoniazid for prevention of TB disease among HIV positives.
A facility-based cross-sectional study design was conducted in public health facilities of West Shewa Zone from January to February 2019. Of the 28 Public health facilities providing HIV/AIDS care and support (HCT and ART services) 13 of them were selected by simple random sampling techniques. Finally, 815 study participants were recruited by systematics sampling techniques & proportional sample size allocation was applied depending on the HIV patient load in each health facility. After reviewing relevant literature, a structured questionnaire adapted from standardized WHO guidelines, prepared for monitoring & evaluation of TB/HIV activities was used to collect data via interviewer.
Of the total, 769 (94.4%) PLHIV were screened for tuberculosis, among which 212 (27.6%) were found to be positive for active tuberculosis. Among 557 (72.4%) individuals eligible for IPT, only 300 (53.9%) were provided IPT; 257 (46.1%) eligible PLHIV were not provided IPT. Resident (adjusted odds ratio [AOR] 5.6), those who didn't attend school (AOR 4.0), primary school (grade 1-8) (AOR 3.2), and secondary school (grade 9-12) (AOR 4.2) were significantly associated with the likelihood of tuberculosis infection.
The present study findings demonstrated that tuberculosis screening for PLHIV at West Shewa Zone public health facilities was improved in comparison with reports from many African countries and other parts of Ethiopia. The IPT implementation rate fell short of both national and WHO guidelines, notwithstanding this improvement. In the study area, diagnostic methods for tuberculosis and existing preventive measures should be improved overall.
结核病是艾滋病毒/艾滋病感染者中最常见的机会性感染和死亡原因。对人类免疫缺陷病毒呈阳性的个体进行结核病常规筛查，以此作为监测减轻该疾病对艾滋病毒阳性患者影响的工作手段。结核病状况评估可识别出通过症状筛查未显示活动性结核病迹象、且将受益于接受异烟肼治疗以预防艾滋病毒阳性者患结核病的艾滋病毒阳性患者。
2019年1月至2月，在西谢瓦地区的公共卫生机构开展了一项基于机构的横断面研究设计。在提供艾滋病毒/艾滋病护理和支持（艾滋病毒检测与咨询及抗逆转录病毒治疗服务）的28家公共卫生机构中，采用简单随机抽样技术选取了其中13家。最后，通过系统抽样技术招募了815名研究参与者，并根据各卫生机构的艾滋病毒患者数量进行了成比例的样本量分配。在查阅相关文献后，使用一份根据世界卫生组织标准化指南改编的结构化问卷来收集数据，该问卷用于结核病/艾滋病毒活动的监测与评估，由访谈员进行访谈。
总共769名（94.4%）艾滋病毒感染者接受了结核病筛查，其中212名（27.6%）被发现患有活动性结核病呈阳性。在557名（72.4%）符合接受间歇预防性治疗条件的个体中，只有300名（53.9%）接受了间歇预防性治疗；257名（46.1%）符合条件的艾滋病毒感染者未接受间歇预防性治疗。常住居民（调整后的优势比[AOR]为5.6）、未上学的人（AOR为4.0）、小学（1至8年级）（AOR为3.2）以及中学（9至12年级）（AOR为4.2）与结核病感染的可能性显著相关。
本研究结果表明，与许多非洲国家及埃塞俄比亚其他地区的报告相比，西谢瓦地区公共卫生机构对艾滋病毒感染者的结核病筛查情况有所改善。尽管有这一改善，但间歇预防性治疗的实施率仍未达到国家和世界卫生组织的指南要求。在研究区域，总体上应改进结核病的诊断方法和现有的预防措施。
