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Epidemiology and Health 2019;e2019028.
DOI: https://doi.org/10.4178/epih.e2019028    [Accepted] Published online June 22, 2019.
Incidence and Predictors of Tuberculosis among HIV-positive Children in Adama Referral Hospital and Medical College, East Shoa Ethiopia: A retrospective follow up study
Masino Tessu Abebe1  , Aklil Hailu Beyen2  , Kenean Getaneh Tlaye3  , Tefera Mulugeta Demelew2 
1Nursing department, College of Health science and Medicine, Wolkite University, Wolkite, Ethiopia
2School of Nursing and Midwifery, College of Health Science, Addis Ababa University, Addis Ababa, Ethiopia
3Nursing Department, Health Science Faculty, Woldia University, Woldia, Ethiopia
Correspondence  Tefera Mulugeta Demelew ,Tel: +251910360495, Email: tefera.mulugeta@aau.edu.et
Received: April 15, 2019  Accepted after revision: June 22, 2019
Abstract
Objectives:
Tuberculosis(TB) is a common condition in children with Human Immunodeficiency Virus (HIV). However, the effect of tuberculosis on the survival of HIV infected children is not well understood. Therefore, the aim of the study is to assess the incidence and predictors of active tuberculosis among HIV positive children in Adama Referral Hospital and Medical College in Adama, Ethiopia.
Method:
A retrospective study was conducted over five years using a checklist to gather data from 428 randomly selected pediatric patient charts. The checklist was adapted from the standardized Anti-Retroviral Therapy (ART) follow up form currently used by ART clinics at the institution. Data was analyzed by bivariate and multivariate analysis using Cox regression proportional hazard models, as appropriate. Survival was calculated and compared with the Kaplan Meier and log rank tests.
Results:
Out of the 466 charts reviewed, 428 patient records were included in the analysis. A total of 67 new tuberculosis cases was observed during the follow up period. Hence, the incidence rate in this cohort was found to be 6.03 per 100 child-years observation. Baseline hemoglobin level <10g/dl (adjusted hazard risk [AHR]:7.04, 95% confidence interval [CI]:1.03-48.15), moderately wasted (AHR: 2.86, 95% CI: 1.02-7.99) and not taking isoniazid preventive therapy(IPT) (AHR: 8.23, 95% CI:2.11-32.06) were among the independent predictors for tuberculosis occurrence.
Conclusion:
Incidence of TB was high, particularly in the pre-ART groups receiving HIV chronic care. Close follow up of HIV positive children is crucial to safeguard them against the development of TB.IPT, averting malnutrition and anemia has also significant importance.
Keywords: Incidence; Predictors; Tuberculosis; Children; HIV; Adama, Ethiopia
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