title: Determinants for tuberculosis in HIV-infected adults in Northwest Ethiopia: a multicentre case-control study.
abstract: OBJECTIVE
  The objective of this study was to identify determinants for tuberculosis (TB) among HIV-infected adults in Northwest Ethiopia.
  
  
  METHODS
  Case-control study.
  
  
  METHODS
  Three hospitals and 10 health centres in Northwest Ethiopia.
  
  
  METHODS
  A total of 446 individuals consented to participate in the study (150 cases and 296 controls). Cases were HIV-infected adults diagnosed with active TB, and controls were HIV-infected adults without active TB.
  
  
  METHODS
  The link between TB and determinants was assessed using logistic regression. Determinants were categorised as sociodemographic, host-related, clinical and environmental.
  
  
  RESULTS
  Smoking (adjusted OR (AOR) 5.47; 95% CI 2.26 to 13.22), presence of a TB patient in the family (AOR 2.66; 95% CI 1.25 to 5.66), alcohol consumption (AOR 2.49; 95% CI 1.29 to 4.80) and chewing khat (AOR 2.22; 95% CI 1.11 to 4.41) were independent determinants for increased occurrence of TB. Highly active antiretroviral therapy (HAART) (AOR 0.25; 95% CI 0.13 to 0.51), isoniazid preventive therapy (IPT) (AOR 0.22; 95% CI 0.11 to 0.41) and cotrimoxazole preventive therapy (AOR 0.32; 95% CI 0.19 to 0.55) had a protective effect against TB.
  
  
  CONCLUSIONS
  HIV-infected adults with substance abuse (tobacco smoking, khat chewing and alcohol) should be prioritised for TB screening. This study reaffirmed that HAART and IPT are some of the best strategies for reducing TB occurrence in HIV-infected adults. These findings provide impetus to intensify tracing of TB household contacts.
authors.affiliation: Institute of Public Health, Heidelberg University, Heidelberg, Germany School of Public Health, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia.
authors.forename: Yihun Mulugeta
authors.initials: YM
authors.lastname: Alemu
authors.affiliation: School of Public Health, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia.
authors.forename: Worku
authors.initials: W
authors.lastname: Awoke
authors.affiliation: Institute of Public Health, Heidelberg University, Heidelberg, Germany Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore.
authors.forename: Annalies
authors.initials: A
authors.lastname: Wilder-Smith
mesh_terms: D000328:Adult; D023241:Antiretroviral Therapy, Highly Active / Q000379:methods; D000995:Antitubercular Agents / Q000627:therapeutic use*; D018791:CD4 Lymphocyte Count; D016022:Case-Control Studies; D060085:Coinfection / Q000453:epidemiology; D005002:Ethiopia / Q000453:epidemiology; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D007538:Isoniazid / Q000627:therapeutic use*; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D012189:Retrospective Studies; D019966:Substance-Related Disorders / Q000453:epidemiology*; D014376:Tuberculosis / Q000150:complications* / Q000517:prevention & control*
chemical_list: D000995:Antitubercular Agents; D007538:Isoniazid
keywords: PUBLIC HEALTH