Prevalence and risk factors of Tuberculosis among HIV patients with a low CD4 count at Komamboga Health Centre III, Kampala

Abstract

Tuberculosis (TB) remains a leading cause of morbidity and mortality among people living with HIV (PLHIV), particularly those with advanced immunosuppression. Despite WHO recommendations for the use of TB LAM testing in patients with low CD4 counts, routine use and data on its impact remain limited in Uganda. This study aimed to determine the prevalence and factors associated with TB among HIV-positive patients with low CD4 counts attending Komamboga Health Centre III in Kampala, Uganda. A cross-sectional study was conducted among 104 HIV-positive adults with CD4 counts <200 cells/mm³. TB LAM testing was used to screen for active TB. Data on sociodemographic, behavioral, and clinical characteristics were collected. Bivariate and multivariate logistic regression analyses were used to identify factors associated with TB positivity. The prevalence of TB among the study population was found to be 15.4%. Although most variables were not significantly associated with TB positivity in adjusted analyses, participants on ART for more than six months had significantly lower odds of testing positive for TB (AOR = 0.26; 95% CI: 0.06–0.91). Residence in semi-urban or urban areas and having comorbidities showed a trend toward higher TB positivity but were not statistically significant. The high TB prevalence among HIV patients with low CD4 counts underscores the need for routine TB LAM testing in similar settings. Sustained ART use significantly reduces TB risk, reaffirming the importance of early initiation and adherence to ART. Integration of TB LAM into routine care and improved TB screening among newly enrolled clients are crucial for early detection and management.