DETERMINANTS OF TUBERCULOSIS AMONG HIV POSITIVES CHILDREN CURRENTLY ON ART IN PUBLIC HEALTH FACILITIES OF GUJI ZONE, SOUTHERN ETHIOPIA: -UNMACHED CASE CONTROL STUDY.

ABSTRACT Background: Next to HIV, TB is the second leading cause of death from an infectious disease worldwide. The WHO declared TB as a global public health emergency in 1993 when many deaths occurred due to TB. Globally, TB has been reported to be one of the major causes of death among children. Approximately 1 million children are estimated to be infected by TB worldwide of which 75% occurs in the 22 high-burden countries including Ethiopia. In high-TB burden countries, childhood TB constitutes 20–40% case load. Objective: To assess the determinants of active tuberculosis among HIV-positive children’s currently on antiretroviral therapy in public health facilities of Guji Zone, southern Ethiopia. Methods: The study was conducted in Guji zone public health facilities, through a facility based unmatched case control study design in the year 2021/2022.By computer generated random sampling method cases and controls were selected proportional to size to the number of patients attending care in each public health facilities. About 123 TB/HIV co-infected patient were selected as cases and 246 HIV infected without TB infection were selected as controls. Data were entered into Epidata version 3.1 and analyzed by using SPSS version 25. Bi-variable and multivariable logistic regression analyses were done. A P-value of < 0.05 was used as the criterion for statistical significance. Result: Clients whose CD4 count 300 per cell (AOR 95% CI: 4.17,2.229-6.912). children who were taking TPT were 0.22 times less likely to develop TB than children who were not on TPT (AOR 95%CI: 0.22, 0.133-0.833). A child who has family history of TB was 2.66 times more likely to have tb than children who has not family history of TB (AOD 95%CI: 2.66, 1.561-4.801). Conclusion and recommendation TB was found to be high among patients with CD4 cell count <300/ml, WHO clinical stage III and IV, with hemoglobin level of less than 12 mg/dL, patients who had not received INH prophylaxis and patients who had contact history with TB patients. An overall contact tracing activities as well as INH prophylactic preventive measures should be strengthened to manage cases as early as possible.