Factors associated with HIV-TB Co-infection among children receiving antiretroviral therapy in Imo State, Nigeria

Background: Nearly 90 % of children living with HIV and tuberculosis are domiciled in Sub-Saharan Africa. Given the paucity of data on TB-HIV co-infection in children, this study aimed to understand the factors associated with co-infection in children receiving antiretroviral therapy (ART) in Imo State, Nigeria. Methods: We used a matched case-control study design in this study. 30 TB-HIV incident cases and 90 control children living with HIV receiving ART were recruited from selected HIV treatment sites in Imo State with a case-control ratio of 1:3. A structured questionnaire was used to collect information on family size, socioeconomic status, passive smoking, household food security, and household TB exposure. Results: Having at least three people living with a child in a room (P = .006, 95 %CI for odds =1.76-28.78), reduced food intake (P=.004, X2 = 8.50). Having a family member living with HIV (P = 0.016, X2 = 5.75) or having symptoms of TB (P = 0.0001, X2 = 50.39) were all found to be significant factors in HIV-TB coinfection in children. The significant factors of passive smoking were the extent to which the respondents think they are exposed to tobacco smoke at home (P = 0.0001, X2 = 24.14), having some members of the family smoke inside the home (P = 0.0001, X2 =17.57), and having some degree of exposure to tobacco smoke in socialization areas outside the household (P = 0.0001, X2 = 22.80). None of the social-economic status factors assessed in this study were found to be significant for co-infection except those who earn income to support the family (P = 0.023, X2 = 11.36) and the hours of work they do each week (P = 0.038, X2 =6.54). Conclusion: After this study, household food security, passive smoking, family size, and household TB exposure are associated with TB-HIV co-infection in children.