Prevention strategy of tuberculosis among HIV positive adolescents in Hawassa town, Southern Ethiopia

Abstract

The study aimed at identifying the determinants of tuberculosis infection among human immunodeficiency virus (HIV) positive adolescents and subsequently develop a prevention strategy for tuberculosis (TB) among HIV positive adolescents in Hawassa town, Ethiopia. The study was conducted from 10 September 2021 to 28 February 2022 in Hawassa town, which is located in the southern part of Ethiopia. The study adopted a sequential exploratory mixed methods study design. A qualitative study was conducted in the first phase, followed by a quantitative study in the second phase. Data for the qualitative phase was collected through face-to-face interviews as well as focus group discussions using an interview guide. Data was collected from adolescents who were diagnosed with TB/HIV or only HIV and treated in chronic care centres, and their guardians. Qualitative data was further collected from key informants who were public officials and focal persons for the TB/HIV prevention/control programme in their institutions. The quantitative data was collected through a structured questionnaire from 321 TB/HIV patients of whom 107 were cases and 214 were controls from four conveniently selected health facilities in Hawassa. Qualitative data was analysed thematically and manually, while quantitative data was analysed using SPSS version 26 and Epi Info version 7.2.5. The study revealed a consistent increase of tuberculosis infection among the adolescents living with HIV owing to failure of good governance and leadership; deterioration of school health services; critical budget shortages; and poor motivation of health professionals. Factors that were found to be independently associated with tuberculosis infection were taking isoniazid preventive therapy (IPT) AOR=0.09, 95% CI (0.01, 0.69) which shows that IPT has a preventive effect against tuberculosis; WHO clinical stages III and IV AOR= 3.64, 95% CI (2.95, 4.49); previous history of tuberculosis AOR=222.18, 95% CI (127.06, 389.59) and history of smoking AOR=112.4, 95%CI (146.83, 940.15). The study concluded that all stakeholders must work together to improve the execution of services for TB/HIV prevention. The contribution of this study is the development of an alternative integrated TB/HIV preventive strategy, which would promote TB/HIV prevention for better health outcomes.