Time to reoccurrence of tuberculosis and its predictors among adult HIV/AIDS patients on ART at public hospitals in East and Horro Guduru Wollega zones, West Ethiopia: a retrospective cohort study.

BACKGROUND

The reoccurrence of Tuberculosis infection is one of the challenging problems in meeting the global Tuberculosis prevention goal. It contributes to morbidity and mortality, economic crisis, spread of infection among the population, and affects health-related quality of life. Despite the public health significance of the problem, there is a paucity of knowledge to well understand the time to reoccurrence of tuberculosis among HIV population and the factors that determine the recurrence of the problem in the context of Ethiopia.

OBJECTIVE

To assess the time to reoccurrence of tuberculosis and its predictors among adult HIV/AIDS patients attending ART clinics at health facilities in East and Horro Guduru wollega zones.

METHODS

A Hospital-based retrospective follow-up study was conducted among HIV/AIDS patients attending the ART clinic from Jan 1, 2015 to Feb, 30, 2020 by collecting information from the medical records of 442 patients. A sampling frame from the ART log book was prepared. A simple random sampling technique from patient records was employed. The structured checklist was used. Bivariable and multivariable Cox regression with crude hazard ratio and the adjusted hazard ratio, respectively, were used to identify independent predictors for the reoccurrence of Tuberculosis. A P-value of < 0.05 with 95% CI was used to declare significantly associated predictors.

RESULT

The median survival time of TB reoccurrence in this study was 72 months. Sex (AHR = 4.90 (95%CI:1.98, 12.53), widowed marital status (AHR = 4.00; 95%CI:1.13, 14.14), occupational status (AHR = 3.45;95%CI: 1.12, 10.64), advanced WHO clinical stages (AHR = 6.98; 95%CI: 1.71, 28.45), recurrence of opportunistic infections (AHR = 10.49; 95%CI:2.14, 51.54), low adherence to Anti-TB drugs (AHR = 2.38; 95%CI:1.01, 5.64), facing multidrug resistance during the preceding episode of TB (AHR = 25.06; 95%CI:6.49, 96.66), CD4 count < 200 (AHR = 10.09 95%CI: 3.62, 28.17), and viral load (AHR = 1.01 (95%CI:1.00, 1.02) were significant predictors of TB reoccurrence among HIV patients.

CONCLUSION

The median survival time among adult HIV patients was higher in the first 80 months of ART initiation and it decreased over the time of ART. Sex, occupational status, marital status, low CD4 count, viral load, advanced WHO clinical stage, reoccurrence of other opportunistic infections, poor adherence to TB treatment, and facing multidrug-resistant TB were independent predictors for reoccurrence of TB among HIV-positive adults.