The Double Burden of TB/HIV co-infection: Evidence from Central Region of Ghana

Abstract The synergistic burden of Tuberculosis (TB) and Human Immunodeficiency Virus (HIV) is a significant health risk in low and middle-income economies. This study estimated the prevalence and predictors of TB/HIV co-infection in the Central region of Ghana. Using a cross-sectional study, we randomly selected five districts and employed a retrospective records review of TB cases registered between 2019 and 2022. A stepwise multivariate logistic regression was used to identify important predictors of TB/HIV co-infection. The overall prevalence of TB/HIV co-infection in the study period was 10.92%. This was highest at 55 (15.54%) among the age group 25 – 40 years. The burden of TB/HIV co-infection was highest at 36 (19.25%) in the Gomoa East district and lowest at 30 (8.38%) in Mfantseman municipal. In the adjusted model, TB patients 60 years and above had 78% lower odds of being HIV infected (AOR: 0.22; 95% CI: 0.08 – 0.66). Males were 37% less likely to be co-infected (AOR: 0.63; 95% CI: 0.42 – 0.96). Also, pulmonary-positive TB patients were 5 times more likely to be co-infected (AOR: 5.04; 95% CI: 1.71 – 14.85). Furthermore, TB patients who died in the course of treatment were 2 times more likely to be infected with HIV (AOR:2.15; 95% CI: 1.05 – 4.40). TB patients treated in the Gomoa East district were 2.7 times more likely to be HIV-infected (AOR: 2.67; 95% CI: 1.34 – 5.35). The burden of TB/HIV co-infection was moderate in the study sites and significantly associated with age, sex, bacteriological confirmation, type of TB, treatment outcome, treatment district, and year of treatment. There is a need for targeted interventions such as community awareness creation that is specific to sexually active female groups. Efforts to improve TB case detection such as health facility-based screening of patients with Respiratory Tract Infections (RTI) and contact tracing should be intensified.