Abstract:
Background
Tuberculosis remains a leading cause of mortality among people living with HIV. Despite the proven efficacy of TB preventive therapy (TPT), its uptake among HIV-positive individuals in Ethiopia might be limited. This study aims to understand the current TPT uptake levels, and associated factors among individuals living with HIV attending Anti retroviral treatment (ART) clinic in Adama and surrounding districts.
Methods
A Cross-sectional study design was used to analyse data from an existing cohort ongoing for the past 2 years, from ART clinics across Adama and nearby districts. The study population are individuals attending ART clinic age 15 and above. The sample size was calculated by single proportion formula and determined to be 1118 participants and simple random sampling was used. Data was drawn from a structured Redcap database. Descriptive statistics were employed to summarize participant characteristics, while inferential statistical analyses were conducted to identify factors associated with the uptake of tuberculosis preventive therapy. Bivariate analysis was initially used followed by multivariable logistic regression to determine independent predictors of TPT uptake. All statistical analyses were performed using SPSS software, with a significance level set at p ≤ 0.05.
Result
Among 1,118 participants, 72.1% (95% CI: 69.4%–74.7%) had initiated tuberculosis preventive therapy (TPT). Females were more likely than males to uptake TPT (AOR = 1.633, 95% CI: 1.198–2 re-engaged after lost to follow-up (AOR = 3.018, 95% CI: 2.094–4.349) and transfer-in from other facilities (AOR = 1.603, 95% CI: 1.097–2.343) were associated with higher TPT uptake. Advanced HIV clinical stage (WHO Stage III/IV) was also positively associated (AOR = 1.768, 95% CI: 1.171–2.669). Facility-level variation was observed, with significantly lower uptake at Geda Health Center (AOR = 0.249, 95% CI: 0.077–0.808)
Conclusion
TPT uptake among PLHIV in Adama and surrounding districts varied by socio-demographic, clinical, and facility-level factors. Targeted interventions are needed to ensure equitable and consistent TPT delivery across all patient groups and health facilities.