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Risk Factors Associated with the Development of Tuberculosis Among HIV-Infected Patients in Khartoum in 2010

1 Public Health Specialist, Federal Ministry of Health, Public Health Institute, Khartoum, Sudan;
2 Professor of Public Health, Ahfad University for Women, Omdurman, Sudan and WHO regional consultant;
3 Epdemiologist, Federal Ministry of Health, Directorate of Epidemiology and Zoonotic diseases, Khartoum, Sudan;
4 Community Physician, Federal Ministry of Health, National Medical Commission, Khartoum, Sudan

Special Issues: Health Promotion and Disease Prevention among Most Vulnerable Populations

Background: Tuberculosis (TB) screening among patients infected with Human Immunodeficiency Virus (HIV) is one of the approaches for controlling TB-HIV co-infection. The absence of typical TB symptoms among HIV-infected patients makes diagnosis challenging. Identifying predisposing risk factors of TB among HIV-infected patients could possibly guide TB diagnosis and treatment. This study was designed to identify some important factors associated with TB among HIV-infected patients and to quantify the strength of this association.
Methodology: In 2010, a case control study was conducted in Khartoum State, Sudan. Cases and controls were selected by simple random sampling with a 1:2 ratio; 97 cases and 194 controls were enrolled in the study. A logistic regression model was built to estimate and quantify the strength of the association between the study variables and the outcome; a p-value less than 0.05 was considered the cut-off point for a significant statistical association.
Results: Past history of TB, CD4 count < 200 cells/µl, late clinical stages, non-employment, and no formal education were found to be risk factors for developing TB among HIV-infected patients. The adjusted ORs and 95% CIs were (6.9: 3.75-12.99), (4.8: 1.57-15.26), (5.8: 1.88-17.96), (2.5: 1.26-5.03), and (2.5: 1.28-4.63), respectively. Poor adherence, marital status, age, and gender are not associated with developing TB among HIV patients.
Conclusion: HIV patients who have at least one of the risk factors found in this analysis are at higher risk of TB; therefore, they should be screened more frequently and treated promptly, especially HIV patients with previous TB.
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