HIV infection and unknown HIV status among tuberculosis patients in Ethiopia: a systematic review and meta-analysis

BACKGROUND AND OBJECTIVE: Each case of human immunodeficiency virus (HIV) infection worsens the global HIV situation, leads to the failure to achieve tuberculosis (TB) control targets worldwide, and impacts on the use of health service resources. We determined the prevalence of HIV infection among TB patients and the proportion of TB patients with unknown HIV status in Ethiopia.

METHODS: We searched PubMed, EMBASE, Google Scholar and Web of Science electronic databases. Heterogeneity of the included studies was checked using the I² statistic and publication bias was assessed using funnel plots and Egger's regression statistical test. We employed a random-effects model to determine the pooled prevalence of HIV infection and unknown HIV status. A sensitivity analysis was also conducted to examine the effect of possible outliers on the overall estimate.

RESULTS: The prevalence of HIV infection among TB patients and the proportion of TB patients with unknown HIV status was respectively 23.4% (95%CI 19.6-27.2) and 6.4% (95%CI 1.7-11.0). Based on geographical location, the prevalence of HIV infection was 31.4% (95%CI 19.2-43.6) in Amhara Region, 23.2% (95%CI 9.9-36.5) in Oromia, 20.9% (95%CI 17.8-24.0) in Addis Ababa and 16.5% (95%CI 12.0-21.0) in Southern Nations, Nationalities and Peoples' Region (SNNPR).

CONCLUSION: In Ethiopia, almost one in four TB patients is infected with HIV. Given the epidemiological variation of Ethiopia, responsive, integrated sustainable programmes for HIV and TB are essential to minimise the epidemics of HIV infection and TB.