In resource limited settings, Tuberculosis (TB) is a major cause of morbidity and mortality among patients on antiretroviral treatment. Ethiopia is one of the 30 high TB burden countries. TB causes burden in healthcare system and challenge the effectiveness of HIV care. This study was to assess incidence and predictors of Tuberculosis among adults on antiretroviral therapy at Debre Markos Referral Hospital, Northwest Ethiopia, 2019. Institution based retrospective follow up study was conducted among adults on ART newly enrolled from 2014 to 2018 at Debre Markos Referral Hospital. Simple random sampling technique was used to select patients chart. Data was entered to EPI- INFO version 7.2.2.6 and analyzed using Stata 14.0. Tuberculosis incidence rate was computed and described using frequency tables. Both bivariable and multivariable Cox proportional hazard models was fitted to identify predictors of TB. Out of the 536 patients chart reviewed, 494 patient records were included in the analysis. A total of 62 patients developed new TB cases during the follow up period of 1000.22 Person Years (PY); which gives an overall incidence rate of 6.19 cases per 100 PY (95% CI: 4.83–7.95). The highest rate was seen within the first year of follow up. After adjustment base line Hemoglobin < 10 g/dl (AHR = 5.25; 95% CI: 2.52–10.95), ambulatory/bedridden patients at enrolment (AHR = 2.31; 95% CI: 1.13–4.73), having fair or poor ART adherence (AHR = 3.22; 95% CI: 1.64–6.31) were associated with increased risk of tuberculosis whereas taking Isoniazid Preventive Therapy (IPT) (AHR = 0.33; 95% CI: 0.12–0.85) were protective factors of TB occurrence. TB incidence was high among adults on ART especially in the first year of enrollment to ART. Low hemoglobin level, ambulatory or bedridden functional status, non-adherence to ART and IPT usage status were found to be independent predictors. Hence, continuous follow up for ART adherence and provision of IPT has a great importance to reduce the risk of TB.

中文翻译：

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埃塞俄比亚西北部德布雷马科斯转诊医院接受抗逆转录病毒治疗的成人结核病的发病率和预测因素：回顾性随访研究。


在资源有限的环境中，结核病 (TB) 是抗逆转录病毒治疗患者发病和死亡的主要原因。埃塞俄比亚是30个结核病高负担国家之一。结核病给医疗保健系统造成负担，并挑战艾滋病毒护理的有效性。本研究旨在评估 2019 年在埃塞俄比亚西北部 Debre Markos 转诊医院接受抗逆转录病毒治疗的成人结核病的发病率和预测因素。基于机构的回顾性随访研究是在 Debre Markos 转诊医院 2014 年至 2018 年新入组的 ART 成人中进行的。使用简单随机抽样技术来选择患者图表。数据输入 EPI-INFO 版本 7.2.2.6 并使用 Stata 14.0 进行分析。使用频率表计算和描述结核病发病率。双变量和多变量 Cox 比例风险模型均适用于识别结核病的预测因子。在审查的 536 名患者图表中，分析了 494 份患者记录。在1000.22人年（PY）的随访期间，共有62名患者出现新的结核病例；总发病率为每 100 PY 6.19 例（95% CI：4.83-7.95）。最高比率出现在随访的第一年内。调整基线后血红蛋白 < 10 g/dl (AHR = 5.25; 95% CI: 2.52–10.95)，入组时卧床/卧床患者 (AHR = 2.31; 95% CI: 1.13–4.73)，ART 依从性一般或较差（AHR = 3.22；95% CI：1.64–6.31）与结核病风险增加相关，而接受异烟肼预防治疗（IPT）（AHR = 0.33；95% CI：0.12–0.85）是结核病发生的保护因素。接受抗逆转录病毒治疗的成年人中结核病发病率很高，尤其是在接受抗逆转录病毒治疗的第一年。 低血红蛋白水平、卧床或卧床功能状态、不遵守 ART 和 IPT 使用状态被发现是独立的预测因素。因此，持续跟踪 ART 依从性和提供 IPT 对于降低结核病风险非常重要。