Table 4.
Unadjusted and adjusted hazard ratios for patient and facility-level factors associated with incident TB among patients enrolling in HIV care in IeDEA-East Africa health facilities, 2003–2012 (n=138,394)
| HR | 95% CI | P-value | aHRb | 95% CI | P-value | ||
|---|---|---|---|---|---|---|---|
| Age at enrollment | 1.004 | (1.002–1.006) | <0.001 | 0.996 | (0.994–0.998) | <0.001 | |
| Sex | |||||||
| Male | 1.447 | (1.394–1.504) | <0.001 | 1.314 | (1.263–1.368) | <0.001 | |
| Female | 1.000 | 1.000 | |||||
| Enrollment Year | 0.924 | (0.916–0.933) | <0.001 | 0.948 | (0.938–0.958) | <0.001 | |
| CD4+ cells/µL at enrollment | |||||||
| Patient-level factors | 0–99 | 1.000 | 1.000 | ||||
| 100–199 | 0.824 | (0.781–0.869) | <0.001 | 0.911 | (0.862–0.963) | 0.001 | |
| 200–350 | 0.806 | (0.765–0.849) | <0.001 | 0.981 | (0.925–1.040) | 0.515 | |
| 351–500 | 0.662 | (0.625–0.701) | <0.001 | 0.837 | (0.779–0.899) | <0.001 | |
| 500+ | 0.440 | (0.411–0.471) | <0.001 | 0.594 | (0.547–0.645) | <0.001 | |
| WHO stage at enrollment | |||||||
| Stage 1 | 1.000 | 1.000 | |||||
| Stage 2 | 1.495 | (1.425–1.568) | <0.001 | 1.412 | (1.343–1.484) | <0.001 | |
| Stage 3 | 2.348 | (2.245–2.456) | <0.001 | 2.097 | (1.992–2.207) | <0.001 | |
| Stage 4 | 2.598 | (2.403–2.809) | <0.001 | 2.240 | (2.054–2.442) | <0.001 | |
| Use of ART | |||||||
| Yes | 1.168 | (1.123–1.214) | <0.001 | 0.843 | (0.798–0.891) | <0.001 | |
| No | 1.000 | 1.000 | |||||
| Use of Isoniazid preventive therapy (IPT) | |||||||
| Yes | 0.716 | (0.684–0.750) | <0.001 | 0.767 | (0.728–0.809) | <0.001 | |
| No | 1.000 | 1.000 | |||||
| History of TBa | 1.622 | (1.504–1.750) | <0.001 | ||||
| Facility type | |||||||
| Public clinic | 1.502 | (1.312–1.719) | <0.001 | 1.392 | (1.196–1.619) | <0.001 | |
| Private clinic | 1.000 | 1.000 | |||||
| Population served | |||||||
| Facility-level factors | Urban | 1.000 | 1.000 | ||||
| Urban and semi-urban | 0.822 | (0.791–0.854) | <0.001 | 0.956 | (0.913–0.999) | 0.049 | |
| Rural and semi-urban | 0.719 | (0.663–0.780) | <0.001 | 0.788 | (0.723–0.859) | 0.000 | |
| Availability of TB treatment within facility | 0.808 | (0.778–0.839) | <0.001 | 0.932 | (0.878–0.989) | 0.021 | |
| Routine TB screening at the HIV clinic | 1.364 | (1.119–1.663) | 0.002 | 1.260 | (1.026–1.542) | 0.027 | |
| Availability of IPT at the HIV clinic | 0.889 | (0.853–0.927) | <0.001 | 1.042 | (0.868–1.243) | 0.678 | |
| Consistency with WHO guidelines for Cotrimoxazole among PLWH | 1.116 | (1.071–1.162) | <0.001 | 0.894 | (0.781–1.024) | 0.106 | |
| Country | Kenya | 1.000 | 1.000 | ||||
| Tanzania | 0.508 | (0.458–0.564) | <0.001 | 0.480 | (0.407–0.565) | 0.000 | |
| Uganda | 1.501 | (1.435–1.569) | <0.001 | 1.176 | (1.030–1.343) | 0.016 |
Abbreviations: CI, confidence interval; HR, hazard ratio; aHR, adjusted hazard ratio;
a
Model includes only Kenya and Uganda, as Tanzania did not report this variable.