Abstract:

Introduction: TB diagnosed in first six months of HAART is commonly associated with serious mortality and morbidity especially in people with severe immunodeficiency, this retrospective nested case control study was conducted to determine the incidence, mortality and predictors for TB diagnosed in the first six months of HAART at Bugando Medical Centre.

Methods: In this retrospective case control study a cohort of 1243 ART naïve patients starting HAART at Bugando Medical Centre from January 2006 to June 2009. From patient record logs and using standard data collecting sheet, all demographic measurements and blood tests were recorded and analyzed using STATA computer software.

Results: A total 1243 patients were included, 4.0% were diagnosed to have TB in the first six months of HAART, people diagnosed to have TB in first six months of HAART had higher mortality compared to non-TB group by 8.9% vs. 1.6% as well as those who had TB diagnosed prior to ART(0.9%). TB diagnosis in the first six months of HAART were highly associated with low CD4 count below 200cell/ml and cough of more than two weeks at time of starting ART.

Conclusions: After ART initiation, the risk of TB diagnosis is higher within the first three months of ART and has higher mortality compared to TB diagnosed prior to HAART initiation. Low baseline CD4 count below 200cells/milliliters, Cough of more than two weeks at baseline are predictors of TB diagnosis in first six months of ART.