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Tuberculosis and its associated risk factors among HIV-positive pregnant women in northwest Ethiopia: A retrospective follow-up study

BACKGROUND: People living with the human immunodeficiency virus have a higher risk of developing active tuberculosis disease. Human immunodeficiency virus infected pregnant women are at a much higher risk of getting active tuberculosis infection, partly due to immune modulation. However, very little...

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Autores principales: Geremew, Habtamu, Dessie, Anteneh Mengist, Anley, Denekew Tenaw, Feleke, Sefineh Fenta, Geremew, Demeke
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10598523/
https://www.ncbi.nlm.nih.gov/pubmed/37885727
http://dx.doi.org/10.1016/j.heliyon.2023.e21382
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author Geremew, Habtamu
Dessie, Anteneh Mengist
Anley, Denekew Tenaw
Feleke, Sefineh Fenta
Geremew, Demeke
author_facet Geremew, Habtamu
Dessie, Anteneh Mengist
Anley, Denekew Tenaw
Feleke, Sefineh Fenta
Geremew, Demeke
author_sort Geremew, Habtamu
collection PubMed
description BACKGROUND: People living with the human immunodeficiency virus have a higher risk of developing active tuberculosis disease. Human immunodeficiency virus infected pregnant women are at a much higher risk of getting active tuberculosis infection, partly due to immune modulation. However, very little is known about the epidemiology of tuberculosis among pregnant women infected with the virus, particularly in resource-limited settings where the burdens of these infections are substantial. Hence, this study aimed to estimate tuberculosis incidence and identify its risk factors among human immunodeficiency virus infected pregnant women in northwest Ethiopia. METHODS: An institutional-based retrospective follow-up study was conducted among pregnant women who were enrolled in option B+ prevention of mother to child transmission service between June 2013 and April 2021 in Pawe district. The Kaplan–Meier survival curve and Weibull regression model were used to estimate survival probability and identify risk factors of tuberculosis, respectively. The best model between the Cox and parametric models was chosen using the Akaike and Bayesian information criteria. RESULT: Out of 289 human immunodeficiency virus infected pregnant women included in the final analysis, 29 (10.03 %) developed active tuberculosis. The overall incidence of tuberculosis was 17.4 per 1000 person-months of observation (95 % CI: 12.1, 25.1). Lack of isoniazid preventive therapy (AHR: 6.68, 95 % CI: 2.67, 16.7), new enrollment to care (AHR: 2.62, 95 % CI: 1.14, 6.03), under-nutrition (AHR: 5.09, 95 % CI: 2.02, 12.83), low CD4 count (AHR: 2.61, 95 % CI: 1.01, 6.78), and suboptimal antiretroviral therapy adherence (AHR: 3.17, 95 % CI: 1.46, 6.86) were predictors of tuberculosis among HIV-positive pregnant women. CONCLUSION: This study found a high incidence of tuberculosis among human immunodeficiency virus infected pregnant women. Thus, strengthening the provision of tuberculosis preventive therapy, reinforcing adherence support, and controlling under-nutrition should be considered to decrease the risk of tuberculosis.
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spelling pubmed-105985232023-10-26 Tuberculosis and its associated risk factors among HIV-positive pregnant women in northwest Ethiopia: A retrospective follow-up study Geremew, Habtamu Dessie, Anteneh Mengist Anley, Denekew Tenaw Feleke, Sefineh Fenta Geremew, Demeke Heliyon Research Article BACKGROUND: People living with the human immunodeficiency virus have a higher risk of developing active tuberculosis disease. Human immunodeficiency virus infected pregnant women are at a much higher risk of getting active tuberculosis infection, partly due to immune modulation. However, very little is known about the epidemiology of tuberculosis among pregnant women infected with the virus, particularly in resource-limited settings where the burdens of these infections are substantial. Hence, this study aimed to estimate tuberculosis incidence and identify its risk factors among human immunodeficiency virus infected pregnant women in northwest Ethiopia. METHODS: An institutional-based retrospective follow-up study was conducted among pregnant women who were enrolled in option B+ prevention of mother to child transmission service between June 2013 and April 2021 in Pawe district. The Kaplan–Meier survival curve and Weibull regression model were used to estimate survival probability and identify risk factors of tuberculosis, respectively. The best model between the Cox and parametric models was chosen using the Akaike and Bayesian information criteria. RESULT: Out of 289 human immunodeficiency virus infected pregnant women included in the final analysis, 29 (10.03 %) developed active tuberculosis. The overall incidence of tuberculosis was 17.4 per 1000 person-months of observation (95 % CI: 12.1, 25.1). Lack of isoniazid preventive therapy (AHR: 6.68, 95 % CI: 2.67, 16.7), new enrollment to care (AHR: 2.62, 95 % CI: 1.14, 6.03), under-nutrition (AHR: 5.09, 95 % CI: 2.02, 12.83), low CD4 count (AHR: 2.61, 95 % CI: 1.01, 6.78), and suboptimal antiretroviral therapy adherence (AHR: 3.17, 95 % CI: 1.46, 6.86) were predictors of tuberculosis among HIV-positive pregnant women. CONCLUSION: This study found a high incidence of tuberculosis among human immunodeficiency virus infected pregnant women. Thus, strengthening the provision of tuberculosis preventive therapy, reinforcing adherence support, and controlling under-nutrition should be considered to decrease the risk of tuberculosis. Elsevier 2023-10-21 /pmc/articles/PMC10598523/ /pubmed/37885727 http://dx.doi.org/10.1016/j.heliyon.2023.e21382 Text en © 2023 The Authors https://creativecommons.org/licenses/by/4.0/This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Research Article
Geremew, Habtamu
Dessie, Anteneh Mengist
Anley, Denekew Tenaw
Feleke, Sefineh Fenta
Geremew, Demeke
Tuberculosis and its associated risk factors among HIV-positive pregnant women in northwest Ethiopia: A retrospective follow-up study
title Tuberculosis and its associated risk factors among HIV-positive pregnant women in northwest Ethiopia: A retrospective follow-up study
title_full Tuberculosis and its associated risk factors among HIV-positive pregnant women in northwest Ethiopia: A retrospective follow-up study
title_fullStr Tuberculosis and its associated risk factors among HIV-positive pregnant women in northwest Ethiopia: A retrospective follow-up study
title_full_unstemmed Tuberculosis and its associated risk factors among HIV-positive pregnant women in northwest Ethiopia: A retrospective follow-up study
title_short Tuberculosis and its associated risk factors among HIV-positive pregnant women in northwest Ethiopia: A retrospective follow-up study
title_sort tuberculosis and its associated risk factors among hiv-positive pregnant women in northwest ethiopia: a retrospective follow-up study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10598523/
https://www.ncbi.nlm.nih.gov/pubmed/37885727
http://dx.doi.org/10.1016/j.heliyon.2023.e21382
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