Master of Public Health

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Browsing Master of Public Health by Author "Jemal Amin"

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    Incidence and Predictors of Tuberculosis among HIV Positive Adults on Antiretroviral Therapy at Adama Hospital Medical College, Southeast Ethiopia: A Retrospective Follow-up Study
    (2025-05-01) Jemal Amin
    ABSTRACT Background: Although antiretroviral treatment (ART) significantly reduces the risk of tuberculosis (TB), the risk remains higher in HIV infected patients than the general population. Consequently, tuberculosis preventive treatment (TPT) is implemented alongside ART to further reduce the incidence of TB in this population. Previous research has not adequately addressed viral load status predictor influences TB incidence among HIV-positive adults. Objective: To determine the incidence and predictors TB among Adult PLHIV on ART at Adama Hospital Medical College, Ethiopia, 2025. Methods: A hospital-based retrospective cohort study was conducted at Adama Hospital Medical College with a total of 640 randomly select records of ART enrolled adults from May 01, 2015 to May 30, 2025. Data was collected by kobo toolbox, exported to an Excel sheet, and then imported to STATA version 17 for analysis. Bivariate and multivariable Cox proportional hazards model was used to identify the predictors of tuberculosis incidence. Adjusted Hazard Ratio with 95% confidence intervals was determined the strength and p-value < 0.05 was declared statistical significance. Results: In this study, a total of 640 participants included in the study, 119(18.59%) of which were developed tuberculosis, and the incidence rate was 4.18 per 100 person- years with a (95% CI: 3.49–4.99). The mean time to develop tuberculosis of HIV positive adults was 8.3 years. Being WHO clinical stage III (AHR: 2.25; 95% CI 1.11-4.57) and WHO clinical stage IV (AHR = 3.50; 95% CI: 1.72–7.12), not received TPT (AHR: 1.80; 95% CI 1.23-2.64), poor ART adherence (AHR: 1.98; 95% CI 1.18-3.30) and viral load test >1000 copies/ml (AHR: 1.80; 95% CI 1.17-2.76) were predictors of incidence of tuberculosis among HIV positive adults. Conclusion: The study found that the overall incidence of tuberculosis among adult HIV infected was high. Adults who had WHO clinical stage III and IV, poor adherence, not received TPT and high viral load test were statistically significant with incidence. Therefore, health care provider shall strength the implement regular viral load monitoring and ensure that ART adherence support programs to improve treatment outcomes. Keywords: Antiretroviral treatment, HIV-positive Adults, Incidence, Predictors, Ethiopia