Incidence of tuberculosis and its predictors among children on antiretroviral therapy in Amhara Region, Ethiopia: a multicentre institution-based retrospective follow-up study
Introduction Tuberculosis (TB) continues to be a significant public health issue, particularly in low-income and middle-income countries. Globally, the End TB Strategy targets an 80% reduction in TB incidence by 2030. Despite this strategy, there remains limited evidence on the incidence of TB among...
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BMJ Publishing Group
2025-02-01
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| author | Wubet Tazeb Wondie Bruck Tesfaye Legesse Gebrehiwot Berie Mekonnen Fikadie Dagnew Baye |
| author_facet | Wubet Tazeb Wondie Bruck Tesfaye Legesse Gebrehiwot Berie Mekonnen Fikadie Dagnew Baye |
| author_sort | Wubet Tazeb Wondie |
| collection | DOAJ |
| description | Introduction Tuberculosis (TB) continues to be a significant public health issue, particularly in low-income and middle-income countries. Globally, the End TB Strategy targets an 80% reduction in TB incidence by 2030. Despite this strategy, there remains limited evidence on the incidence of TB among HIV-infected children after the test-and-treat strategies in Amhara Region. Hence, this study aimed to assess the incidence of TB and its predictors among children on antiretroviral therapy (ART) in Amhara Region, which is the second largest region in Ethiopia and located in the northwestern, northeastern and north-central parts of Ethiopia.Methods A multicentre institution-based retrospective follow-up study was conducted on 421 HIV-infected children receiving ART from July 2014 to March 2022. The study participants were selected using simple random technique. National antiretroviral intake and follow-up forms were used to gather data through the KoBo Toolbox. Stata V.17 was used for data analysis. The Kaplan-Meier curve was applied to estimate failure time, and the log-rank test was employed to compare groups of predictors. To identify TB predictors, Gompertz regression models, both bivariable and multivariable, were constructed. Ultimately, a 95% CI adjusted HR (AHR) was calculated, and variables with a p value less than 0.05 were considered statistically significant.Results A total of 421 children with a record completeness rate of 97.9% were analysed in the study. The TB incidence rate in children on ART was 2.16 (95% CI 1.52, 3.05) per 100 child-year observations. Anaemia at baseline (AHR: 3.83; 95% CI 1.46, 10.04), never taking TB preventive treatment (TPT) (AHR: 3.78; 95% CI 1.44, 9.94), wasting (AHR: 2.53; 95% CI 1.19, 5.38) and not initiating ART within 7 days (AHR: 2.35; 95% CI 1.15, 4.78) were significant predictors of TB in children.Conclusion The incidence of TB in children on ART was relatively high. HIV-positive children presenting with anaemia, those who never took TPT, wasted children and those with late initiation of ART were prone to the occurrence of TB. Therefore, prioritising anaemia treatment, TB preventive therapy, nutritional counselling and timely initiation of ART are essential to curb the TB burden. |
| format | Article |
| id | doaj-art-116efd17774a417794afad2a77cacb2e |
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| spelling | doaj-art-116efd17774a417794afad2a77cacb2e2025-08-20T02:13:45ZengBMJ Publishing GroupBMJ Open2044-60552025-02-0115210.1136/bmjopen-2024-093808Incidence of tuberculosis and its predictors among children on antiretroviral therapy in Amhara Region, Ethiopia: a multicentre institution-based retrospective follow-up studyWubet Tazeb Wondie0Bruck Tesfaye Legesse1Gebrehiwot Berie Mekonnen2Fikadie Dagnew Baye3Department of Pediatrics and Child Health Nursing, Ambo University College of Medicine and Public Health, Ambo, EthiopiaDepartment of Pediatrics and Neonatal Nursing, Wollega University, Nekemte, EthiopiaDepartment of Pediatrics and Child Health Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, EthiopiaDepartment of Pediatrics and Child Health Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, EthiopiaIntroduction Tuberculosis (TB) continues to be a significant public health issue, particularly in low-income and middle-income countries. Globally, the End TB Strategy targets an 80% reduction in TB incidence by 2030. Despite this strategy, there remains limited evidence on the incidence of TB among HIV-infected children after the test-and-treat strategies in Amhara Region. Hence, this study aimed to assess the incidence of TB and its predictors among children on antiretroviral therapy (ART) in Amhara Region, which is the second largest region in Ethiopia and located in the northwestern, northeastern and north-central parts of Ethiopia.Methods A multicentre institution-based retrospective follow-up study was conducted on 421 HIV-infected children receiving ART from July 2014 to March 2022. The study participants were selected using simple random technique. National antiretroviral intake and follow-up forms were used to gather data through the KoBo Toolbox. Stata V.17 was used for data analysis. The Kaplan-Meier curve was applied to estimate failure time, and the log-rank test was employed to compare groups of predictors. To identify TB predictors, Gompertz regression models, both bivariable and multivariable, were constructed. Ultimately, a 95% CI adjusted HR (AHR) was calculated, and variables with a p value less than 0.05 were considered statistically significant.Results A total of 421 children with a record completeness rate of 97.9% were analysed in the study. The TB incidence rate in children on ART was 2.16 (95% CI 1.52, 3.05) per 100 child-year observations. Anaemia at baseline (AHR: 3.83; 95% CI 1.46, 10.04), never taking TB preventive treatment (TPT) (AHR: 3.78; 95% CI 1.44, 9.94), wasting (AHR: 2.53; 95% CI 1.19, 5.38) and not initiating ART within 7 days (AHR: 2.35; 95% CI 1.15, 4.78) were significant predictors of TB in children.Conclusion The incidence of TB in children on ART was relatively high. HIV-positive children presenting with anaemia, those who never took TPT, wasted children and those with late initiation of ART were prone to the occurrence of TB. Therefore, prioritising anaemia treatment, TB preventive therapy, nutritional counselling and timely initiation of ART are essential to curb the TB burden.https://bmjopen.bmj.com/content/15/2/e093808.full |
| spellingShingle | Wubet Tazeb Wondie Bruck Tesfaye Legesse Gebrehiwot Berie Mekonnen Fikadie Dagnew Baye Incidence of tuberculosis and its predictors among children on antiretroviral therapy in Amhara Region, Ethiopia: a multicentre institution-based retrospective follow-up study BMJ Open |
| title | Incidence of tuberculosis and its predictors among children on antiretroviral therapy in Amhara Region, Ethiopia: a multicentre institution-based retrospective follow-up study |
| title_full | Incidence of tuberculosis and its predictors among children on antiretroviral therapy in Amhara Region, Ethiopia: a multicentre institution-based retrospective follow-up study |
| title_fullStr | Incidence of tuberculosis and its predictors among children on antiretroviral therapy in Amhara Region, Ethiopia: a multicentre institution-based retrospective follow-up study |
| title_full_unstemmed | Incidence of tuberculosis and its predictors among children on antiretroviral therapy in Amhara Region, Ethiopia: a multicentre institution-based retrospective follow-up study |
| title_short | Incidence of tuberculosis and its predictors among children on antiretroviral therapy in Amhara Region, Ethiopia: a multicentre institution-based retrospective follow-up study |
| title_sort | incidence of tuberculosis and its predictors among children on antiretroviral therapy in amhara region ethiopia a multicentre institution based retrospective follow up study |
| url | https://bmjopen.bmj.com/content/15/2/e093808.full |
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