Tuberculosis and its association with CD4+ T cell count among adult HIV positive patients in Ethiopian settings: a systematic review and meta-analysis
Abstract Background Tuberculosis (TB) and HV have been intertwined and makeup a deadly human syndemic worldwide, especially in developing countries like Ethiopia. Previous studies have reported different TB incidences and its association with CD4+ T cell counts among HIV positive patients in Ethiopi...
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| Format: | Article |
| Language: | English |
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BMC
2020-05-01
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| Series: | BMC Infectious Diseases |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12879-020-05040-4 |
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| author | Demeke Geremew Mulugeta Melku Aklilu Endalamaw Berhanu Woldu Alebachew Fasil Markos Negash Habtamu Wondifraw Baynes Habtamu Geremew Takele Teklu Tekalign Deressa Belay Tessema Ulrich Sack |
| author_facet | Demeke Geremew Mulugeta Melku Aklilu Endalamaw Berhanu Woldu Alebachew Fasil Markos Negash Habtamu Wondifraw Baynes Habtamu Geremew Takele Teklu Tekalign Deressa Belay Tessema Ulrich Sack |
| author_sort | Demeke Geremew |
| collection | DOAJ |
| description | Abstract Background Tuberculosis (TB) and HV have been intertwined and makeup a deadly human syndemic worldwide, especially in developing countries like Ethiopia. Previous studies have reported different TB incidences and its association with CD4+ T cell counts among HIV positive patients in Ethiopia. Thus, the goal of this meta-analysis was, first, to determine pooled incident TB among adult HIV positive patients, and second, to assess the association between incident TB and baseline CD4+ T cell count strata’s. Methods We searched PubMed, Cochrane library, Science Direct and Google scholar databases from June 1 to 30, 2018. The I2 statistics and Egger’s regression test was used to determine heterogeneity and publication bias among included studies respectively. A random effects model was used to estimate pooled incident TB and odds ratio with the respective 95% confidence intervals using Stata version 11.0 statistical software. Results A total of 403 research articles were identified, and 10 studies were included in the meta-analysis. The pooled incident TB among adult HIV infected patients in Ethiopia was 16.58% (95% CI; 13.25–19.91%). Specifically, TB incidence in Pre-ART and ART was 17.16% (95% CI; 7.95–26.37%) and 16.24% (95% CI; 12.63–19.84%) respectively. Moreover, incident TB among ART receiving patients with baseline CD4+ T cell count < and > 200 cells/mm3 was 28.86% (95% CI; 18.73–38.98%) and 13.7% (95% CI; 1.41–25.98%) correspondingly. The odds of getting incident TB was 2.88 (95% CI; 1.55–5.35%) for patients with baseline CD4+ T cell count < 200 cells/mm3 compared to patients with baseline CD4+ T cell count > 200 cells/mm3. Conclusion High incident TB among adult HIV positive patients was estimated, especially in patients with CD4+ T cell count < 200 cells/mm3. Therefore, Early HIV screening and ART initiation, as well as strict compliance with ART and increasing the coverage of TB preventive therapy to more risky groups are important to prevent the problem. Trial registration Study protocol registration: CRD42018090802 . |
| first_indexed | 2024-12-23T10:05:24Z |
| format | Article |
| id | doaj.art-cad1fbc0759a4d4a97197c3eb93029e1 |
| institution | Directory Open Access Journal |
| issn | 1471-2334 |
| language | English |
| last_indexed | 2024-12-23T10:05:24Z |
| publishDate | 2020-05-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Infectious Diseases |
| spelling | doaj.art-cad1fbc0759a4d4a97197c3eb93029e12022-12-21T17:51:06ZengBMCBMC Infectious Diseases1471-23342020-05-0120111010.1186/s12879-020-05040-4Tuberculosis and its association with CD4+ T cell count among adult HIV positive patients in Ethiopian settings: a systematic review and meta-analysisDemeke Geremew0Mulugeta Melku1Aklilu Endalamaw2Berhanu Woldu3Alebachew Fasil4Markos Negash5Habtamu Wondifraw Baynes6Habtamu Geremew7Takele Teklu8Tekalign Deressa9Belay Tessema10Ulrich Sack11Department of Immunology and Molecular Biology, School of Biomedical and Laboratory Sciences, University of GondarDepartment of Hematology and Immunohematology, School of Biomedical and Laboratory Sciences, University of GondarDepartment of Pediatrics and Child Health Nursing, School of Health Sciences, College of Medicine and Health Sciences, Bahir Dar UniversityDepartment of Hematology and Immunohematology, School of Biomedical and Laboratory Sciences, University of GondarDepartment of Clinical Chemistry, School of Biomedical and Laboratory Sciences, University of GondarDepartment of Immunology and Molecular Biology, School of Biomedical and Laboratory Sciences, University of GondarDepartment of Clinical Chemistry, School of Biomedical and Laboratory Sciences, University of GondarDepartment of Reproductive Health, School of Public Health, Debre Markos UniversityDepartment of Immunology and Molecular Biology, School of Biomedical and Laboratory Sciences, University of GondarEthiopian Public Health Institute, HIV/AIDS and TB Research DirectorateDepartment of Medical Microbiology, School of Biomedical and Laboratory Sciences, University of GondarInstitute of Clinical Immunology, Medical Faculty, University of LeipzigAbstract Background Tuberculosis (TB) and HV have been intertwined and makeup a deadly human syndemic worldwide, especially in developing countries like Ethiopia. Previous studies have reported different TB incidences and its association with CD4+ T cell counts among HIV positive patients in Ethiopia. Thus, the goal of this meta-analysis was, first, to determine pooled incident TB among adult HIV positive patients, and second, to assess the association between incident TB and baseline CD4+ T cell count strata’s. Methods We searched PubMed, Cochrane library, Science Direct and Google scholar databases from June 1 to 30, 2018. The I2 statistics and Egger’s regression test was used to determine heterogeneity and publication bias among included studies respectively. A random effects model was used to estimate pooled incident TB and odds ratio with the respective 95% confidence intervals using Stata version 11.0 statistical software. Results A total of 403 research articles were identified, and 10 studies were included in the meta-analysis. The pooled incident TB among adult HIV infected patients in Ethiopia was 16.58% (95% CI; 13.25–19.91%). Specifically, TB incidence in Pre-ART and ART was 17.16% (95% CI; 7.95–26.37%) and 16.24% (95% CI; 12.63–19.84%) respectively. Moreover, incident TB among ART receiving patients with baseline CD4+ T cell count < and > 200 cells/mm3 was 28.86% (95% CI; 18.73–38.98%) and 13.7% (95% CI; 1.41–25.98%) correspondingly. The odds of getting incident TB was 2.88 (95% CI; 1.55–5.35%) for patients with baseline CD4+ T cell count < 200 cells/mm3 compared to patients with baseline CD4+ T cell count > 200 cells/mm3. Conclusion High incident TB among adult HIV positive patients was estimated, especially in patients with CD4+ T cell count < 200 cells/mm3. Therefore, Early HIV screening and ART initiation, as well as strict compliance with ART and increasing the coverage of TB preventive therapy to more risky groups are important to prevent the problem. Trial registration Study protocol registration: CRD42018090802 .http://link.springer.com/article/10.1186/s12879-020-05040-4TuberculosisHIVCD4+ T cellMeta-analysisEthiopia |
| spellingShingle | Demeke Geremew Mulugeta Melku Aklilu Endalamaw Berhanu Woldu Alebachew Fasil Markos Negash Habtamu Wondifraw Baynes Habtamu Geremew Takele Teklu Tekalign Deressa Belay Tessema Ulrich Sack Tuberculosis and its association with CD4+ T cell count among adult HIV positive patients in Ethiopian settings: a systematic review and meta-analysis BMC Infectious Diseases Tuberculosis HIV CD4+ T cell Meta-analysis Ethiopia |
| title | Tuberculosis and its association with CD4+ T cell count among adult HIV positive patients in Ethiopian settings: a systematic review and meta-analysis |
| title_full | Tuberculosis and its association with CD4+ T cell count among adult HIV positive patients in Ethiopian settings: a systematic review and meta-analysis |
| title_fullStr | Tuberculosis and its association with CD4+ T cell count among adult HIV positive patients in Ethiopian settings: a systematic review and meta-analysis |
| title_full_unstemmed | Tuberculosis and its association with CD4+ T cell count among adult HIV positive patients in Ethiopian settings: a systematic review and meta-analysis |
| title_short | Tuberculosis and its association with CD4+ T cell count among adult HIV positive patients in Ethiopian settings: a systematic review and meta-analysis |
| title_sort | tuberculosis and its association with cd4 t cell count among adult hiv positive patients in ethiopian settings a systematic review and meta analysis |
| topic | Tuberculosis HIV CD4+ T cell Meta-analysis Ethiopia |
| url | http://link.springer.com/article/10.1186/s12879-020-05040-4 |
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