An evaluation of collaboration in the TB and HIV control programme in Oromia Region, Ethiopia: Seven years of retrospective data

Abstract

Background: Globally, HIV and tuberculosis (TB) are a leading cause of death if they occur as co-morbidities in affected individuals. The aim of this study was to evaluate the collaboration between TB and HIV control activities by determining the co-morbidity rate in Oromia Region, Ethiopia, during the period 2009–2015. Methods: A retrospective health facility-based study was conducted. Data were collected from health facilities implementing the directly observed treatment short-course (DOTS) strategy in the region. A structured World Health Organization (WHO) reporting format was used as the data collection tool. Pre-antiretroviral therapy (ART)/voluntary counselling and testing for HIV (VCT) and TB unit registers were considered as the data sources. Data were collected quarterly and analyzed using IBM SPSS Statistics version 20. The odds ratio was used to assess statistical differences among variables. Results: A total of 115 268 TB patients were counselled and tested for HIV during the study period. Among the patients tested, 60 086 (52.1%) were male, of whom 13 680 (11.8%) were found to have an HIV infection. Among TB patients who were co-infected with HIV, there were slightly higher odds of HIV infection in females than in males (odds ratio 1.13, 95% confidence interval 1.09–1.17). Between 2009 and 2013, about 56% of TB and HIV co-morbid patients were put on co-trimoxazole preventive therapy (CPT) and 35% on ART. HIV infection occurred predominantly within the age group of 25–34 years (31%). On the other hand, 197 152 HIV-infected patients were screened for TB symptoms and 8.4% were found to have active TB. The odds of having TB among males who were initially infected with HIV were higher as compared to females (odds ratio 1.31, 95% confidence interval 1.27–1.37). Conclusions: The prevalence of TB and HIV co-morbidity was 11.8% at TB clinics in the region. Low proportions of co-infected patients were put on CPT and ART. Therefore, it is essential to strengthen the WHO recommended TB and HIV collaborative activities in the region to reduce the burden of co-morbidity and mortality. Keywords: Antiretroviral therapy, Co-morbidity rate, Co-trimoxazole preventive therapy, Ethiopia, Human immunodeficiency virus, Tuberculosis, Oromia Region