Incidence and predictors of tuberculosis among HIV-positive adults on antiretroviral therapy at Debre Markos Referral Hospital, Northwest Ethiopia: A retrospective record review

Incidence and predictors of tuberculosis among HIV-positive adults on antiretroviral therapy at Debre Markos Referral Hospital, Northwest Ethiopia: A retrospective record review | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research article Incidence and predictors of tuberculosis among HIV-positive adults on antiretroviral therapy at Debre Markos Referral Hospital, Northwest Ethiopia: A retrospective record review Belisty Temesgen, Getiye Dejenu Kibret, Nakachew Mekonnen Alamirew, and 4 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.2.11527/v5 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 27 Nov, 2019 Read the published version in BMC Public Health → Version 5 posted 4 You are reading this latest preprint version Show more versions Abstract Background: Tuberculosis is the leading cause of morbidity and mortality among people living with human immunodeficiency virus. Almost one-third of deaths among people living with human immunodeficiency virus are attributed to tuberculosis. Despite this evidence, in Ethiopia, there is a scarcity of information regarding the incidence and predictors of tuberculosis among people living with HIV. Thus, this study assessed the incidence and predictors of tuberculosis among HIV-positive adults on antiretroviral therapy. Methods: This study was a retrospective record review including 544 HIV-positive adults on antiretroviral therapy at Debre Markos Referral Hospital between January 1, 2012 and December 31, 2017. The study participants were selected using a simple random sampling technique. The data extraction format was adapted from antiretroviral intake and follow-up forms. Cox-proportional hazards regression model was fitted and Cox-Snell residual test was used to assess the goodness of fit. Tuberculosis free survival time was estimated using the Kaplan-Meier survival curve. Both the bi-variable and multivariable Cox-proportional hazard regression models were used to identify predictors of tuberculosis. Results: In the final analysis, a total of 492 HIV-positive adults were included, of whom, 83 (16.9%) developed tuberculosis at the time of follow-up. This study found that the incidence of tuberculosis was 6.5 (95% CI: 5.2, 8.0) per 100-person-years (PY) of observation. Advanced World Health Organization clinical disease stage (III and IV) (AHR: 2.1, 95% CI: 1.2, 3.2), being ambulatory and bedridden (AHR: 1.8, 95% CI: 1.1, 3.1), baseline opportunistic infections (AHR: 2.8, 95% CI: 1.7, 4.4), low hemoglobin level (AHR: 3.5, 95% CI: 2.1, 5.8), and not taking Isonized Preventive Therapy (AHR: 3.9, 95% CI: 1.9, 7.6) were found to be the predictors of tuberculosis. Conclusion: The study found that there was a high rate of tuberculosis occurrence as compared to previous studies. Baseline opportunistic infections, being ambulatory and bedridden, advanced disease stage, low hemoglobin level, and not taking Isonized Preventive Therapy were found to be the predictors of tuberculosis. Therefore, early detection and treatment of opportunistic infections like tuberculosis should get a special attention. Keywords: Debre Markos, HIV, Incidence, Predictors, tuberculosis Health Policy Debre Markos HIV Incidence Predictors tuberculosis Figures Figure 1 Figure 2 Background Tuberculosis (TB) is the leading cause of morbidity and mortality among People Living with Human Immunodeficiency Virus (PLHIV) [ 1 ]. PLHIV are 20 times more likely to develop TB as compared to those without HIV [ 2 , 3 ]. In 2017, an estimated 10 million people developed TB with 1.6 million succumbing to the disease, of whom, 9% were PLHIV. In the same year, approximately 300,000 people died due to Acquired Immunodeficiency Syndrome (AIDS)-related TB worldwide, with 72% of these deaths occurring in Africa [ 4 ]. Sub-Saharan Africa (SSA) bears the highest (74%) burden of all TB cases [ 5 , 6 ]. Ethiopia is one of the SSA countries with the highest prevalence of TB/HIV co-infection and ranked seventh among the world’s 30 highest TB burden countries. In 2017, according to the Centers for Diseases Control (CDC) and Prevention report, the incidence rate of TB in Ethiopia was 164 cases per 100,000 population including approximately 7% who were PLHIV. In the same year, the mortality rate of TB patients in Ethiopia was 24 per 100,000 population [ 7 , 8 ]. A range of interventions have been implemented at the global and local levels to tackle this challenge. For example, integrated management of TB/HIV co-infection in a single health facility via using a single health care provider to deliver integrated therapy and manage both diseases efficiently. In addition, a scale-up of Antiretroviral Therapy (ART) was introduced aimed to reduce HIV-related morbidity and mortality as well as to increase the survival of HIV-infected patients [ 9-12 ]. The Ethiopian government has adapted and implemented different strategies to reduce TB related morbidity and mortality among PLHIV. For example, the Ministry of Health (MOH) decentralized TB/HIV co-infection care services from hospitals to health centers and strengthened referral systems to improve TB care and treatment at the community level [ 13 ]. In addition, early initiation of ART and early screening of TB, prior to provision of Isonized Preventive Therapy (IPT) [ 14 , 15 ] and Co-trimoxazole Prophylactic Therapy (CPT), were interventions implemented to reduce the incidence of TB among PLHIV [ 16-20 ]. Although the incidence of TB among HIV-positive adults in Ethiopia has improved due to different interventions, it remains the major cause of death among PLHIV. Previous Ethiopian studies have documented that the incidence of TB among HIV-positive adults ranged from 3.3 per 100 PY of observation in Addis Ababa [ 21 ] to 8.6 per 100 PY of observation in Afar Region [ 22 ]. Previous Ethiopian-based studies have identified a number of contributing factors to increasing TB occurrence among HIV-positive adults including household family size between three to four individuals, cigarette smoking , not taking IPT, not taking CPT, low baseline CD4 counts, advanced World Health Organization (WHO) clinical disease stages (Stage II or IV), and having a history of diabetic mellitus [ 22-24 ]. The Ethiopian government targeted a reduction of TB related deaths by 90% and TB incidence by 80% by 2030 from 2015 levels [ 25 ]. To evaluate this ambitious plan, current and up-to-date information related to the occurrence of TB is vital. Therefore, this retrospective record review explored the incidence of TB among HIV-positive adults at Debre Markos Referral Hospital. Results obtained from this study will contribute to evidence for policy makers and program planners working at various levels of TB control programs, as well as informing health care professionals in the areas of TB control and prevention. Methods Study design , area, and period A retrospective record review was conducted at Debre Markos Referral Hospital of applicable patient records from between January 1, 2012 and December 31, 2017. Debre Markos Referral Hospital is located in Debre Markos Town, which is located 299 km from Addis Ababa, the capital city of Ethiopia and 265 km from Bahir-Dar, the main city of Amhara Regional State. The hospital serves more than 3.5 million people in East Gojjam Zone and neighboring areas. Apart from other services, the hospital has been providing ART follow-up care services since 2005. In the hospital, the recorded number of HIV-positive people ever started ART was 3,716, of whom, 1, 569 HIV-positive adults started ART care between January 1, 2012 and December 31, 2017. Population All HIV-positive adults ever started ART at Debre Markos Referral Hospital and who had at least one month of ART follow-up from January 1, 2012 to December 31, 2017 were the target population for this study. All HIV-positive adults ever started ART from January 1, 2012 to December 31, 2017, however, HIV-positive adults on ART who had TB at the beginning of the follow-up and those who had incomplete baseline data for important variables (i.e., WHO stage, CD4 counts, hemoglobin, (Hgb), IPT, CPT and level of ART adherence) were excluded from the study. Sample size determination and sampling procedures The minimum required sample size for this study was calculated using a sample size determination formula for survival analysis using Stata™ Version 13 statistical software by considering CD4 count, functional status, and WHO clinical staging as major exposure variables. It was calculated by considering the following statistical assumptions: two-sided significant level (α) of 5 %, power 80 %, Z a/2 = value at 95 % CI =1.96, q 1 : proportion of subjects that are in group 1 (exposed), q 0: proportion of subjects that are in group 2 (unexposed); 1-q 1 , HR: hazard ratio, and probability of event (E) for functional status were taken from a study conducted at the University of Gondar Teaching Hospital (0.33) [ 23 ]. Finally, the calculated sample size for this study was 544. To select the study participants, the records of all HIV-positive adults ever started ART and recorded from January 1, 2012 to December 31, 2017 were sorted. Then, the study participants were selected using a simple random sampling technique through computer-generated numbers. We selected this follow-up period for two reasons: : first, we intended to have a nearest six years of follow-up; and second, to take advantage of standardized ART documentation and reporting formats used during this period. Data collection tool and procedures The data extraction tool was prepared from the ART entry and follow-up forms. To ensure data quality, before data collection, the data extraction tool was prepared carefully from a standardized ART intake and follow-up forms. Furthermore, before the beginning of data collection, we verified consistency between data recording systems and the prepared checklist by randomly selecting and completing a few chart reviews which resulted in minor amendments of the data collection tool. Three BSc nurses who have been working in the ART clinic of Debre Markos Referral Hospital collected the data. Two days of training was given for both data collectors and supervisor concerning the data collection tool and collection process. The supervisor and principal investigators performed a strict follow-up and supervision throughout the entire data collection period. The most recent laboratory test results before starting ART were considered as a baseline value. If there were no pre-treatment laboratory test results, obtained at the time of ART initiation, test results done within one month of ART initiation were used as a baseline data. In case of two results obtained within a month, the mean value was computed and taken as a baseline. Variables of the Study The dependent variable was the time to develop TB. The predictor variables were: Socio-demographic characteristics ( age, sex, marital status, residence, family size, level of education, and occupation), Baseline clinical and laboratory characteristics ( WHO clinical stage, CD4 cell count, hemoglobin level, history of TB, and history of opportunistic infections (OIs) and body mass index (BMI), and ART and other medication-related characteristics ( type ART regimens, regimen change, ART side effects, ART adherence, IPT, and CPT). In this study, the focus was on health care documentation of the event (the occurrence of TB) for HIV-positive adults in cases where TB developed after ART initiation until the end of the study. This was ascertained by review of patient records. In this study, the study participants were classified as censored in either of the following conditions: if lost to follow-up or died before developing TB or if alive at the end of the study, but didn’t develop TB and took anti-TB medications. These elements were ascertained by reviewing patient records. Lost to follow-up was defined as an HIV-positive patient missing an ART appointment for one to three months [ 26 ]. Adherence was classified as good, fair, or poor, according to the percentage of drug dosage calculated from a monthly total dose of ART drugs; hence, good was reported if equal to or greater than 95% or ≤ 3 dose missing per month, fair if 85-94% or 4-8 dose missing per month, or poor if less than 85% or ≥ 9 dose missing per month [ 27 ]. Low hemoglobin level was defined as Hgb level less than to 10 g/dl. Opportunistic infections were diagnosed if HIV-positive adults developed any morbidities after starting ART, as documented by the health care professionals. Data processing and analysis Data were entered using EPI-data™ Version 4.2, and analyzed using STATA Version 13 statistical software. Patient’s follow-up characteristics for continuous data were described in terms of central tendency, dispersion, and frequency distribution for categorical data. At the end of follow-up, the outcome of each study participant was dichotomized into censored or event. The necessary assumption of Cox proportional hazard regression model was checked using Schoenfeld residual and Log-Log plot tests. In addition, the model goodness of fit was assessed using Cox-Snell residual test and model with the least value of Akaike’s information criteria selected as the best model. The Kaplan Meier survival curve was used to estimate the TB free survival time of HIV-positive adults on ART. Log rank test was used to compare the survival curves of different categorical explanatory variables. Bi-variable Cox-proportional hazard regression model was used to screen variables for the final model. Variables having p-value ≤ 0.25 in the bi-variable analysis were fitted into the multivariable Cox-proportional hazard regression model. Finally, adjusted hazard ratio with its corresponding 95% confidence interval was reported to declare the presence of significant association between the explanatory and outcome variables. Results Socio-demographic characteristics of participants After removal of fifty-two (52) incomplete records, 492 HIV-positive adult charts were included in the final analysis. The median age of the entire cohort was 33.0 years (IQR: 27, 40 years). More than half (53.6%) of the study participants were female and more than three fourth (78.86%) of the participants disclosed their HIV status (Table 1). Baseline clinical, laboratory, ART, and other medication-related information Clinically, more than half (61.8%) of the study participants were classified as WHO clinical stage I/II. The mean baseline CD4 cell count of the study participants was 252.7 cell /mm 3 (SD: 9.5 cell /mm 3 ). In addition, the majority (90.43%) of study participants had a Hgb of 10 gm/dl and more. Almost, one-third (32.93%) of the participants had baseline OIs. Regarding functional status, the majority (81.2%) of study participants were classified as working functional status. At baseline, less than one-third (29.47%) of the participants were undernourished (BMI < 18.5). About 5% of the participants had a history of initial regimen change during follow-up. The majority (95.53%) of participants had a history of good adherence. Moreover, the majority (85.98%) of participants took CPT; however, only 36.38% received IPT (Table 2). Incidence of Tuberculosis In this study, a total of 492 study participants were followed for a different period, contributing a cohort of 1285.54 PY of observation. During the follow-up period, 83 (16.9%) of the study participants experienced TB with an overall incidence rate of TB of 6.5 (95% CI: 5.2, 8.0) per 100 PY of observation. A 14.5% TB incidence rate (95% CI: 11.3, 18.7 per 100 PY) was highest in the first year of follow-up, decreasing in subsequent years. The cumulative probability of TB free survival at the end of one year, two, three, four, five and six years were 0.87, 0.84, 0.82, 0.80, 0.79, and 0.78 respectively. The mean TB free survival time of the entire follow up was 60.8 months (95% CI: 58.2, 63.1 months) (Figure 1). Bi-variable and multivariable Cox-regression analysis Through multivariable Cox-regression analysis, advanced WHO clinical stages (III and IV), baseline OIs, being ambulatory and bedridden, low hemoglobin level (<10g/dl), and not taking IPT were found to be significant predictors of TB. In this study, the hazard of developing TB among HIV-positive adults on ART who were classified as WHO clinical stage III and IV at baseline was 2.1 (95% CI: 1.2, 3.2) times higher as compared to those classified as WHO Stages I and II. Similarly, the hazard of developing TB among HIV-positive adults classified as ambulatory and bedridden at baseline was 1.8 (95% CI: 1.1, 3.1) times higher as compared to those who were classified as working functional status. In addition, the hazard of developing TB among patients who had OIs at baseline was 2.8 times (95% CI: 1.7, 4.4) higher as compare to those who were OIs free at baseline. Furthermore, the hazard of developing TB among patients presenting with Hgb level less than 10g/dl during ART initiation was 3.5 (95%CI: 2.1, 5.8) times higher than those with Hgb levels greater than or equal to 10g/dl. Lastly, HIV-positive adults on ART who did not take IPT were 3.9 (95% CI: 1.9, 7.6) times more likely to develop TB as compared to those who took IPT (Table 3). The goodness of fit for the model was assessed using a Cox-Snell residual test (Figure 2). Discussion Tuberculosis is a major public health challenge and remains the most commonly diagnosed OI among PLHIV [ 3 ]. Therefore, we conducted this retrospective record review to determine the incidence and predictors of TB among HIV-positive adults at Debre Markos Referral Hospital. In this study, the overall incidence of TB among HIV-positive adults at Debre Markos Referral Hospital was 6.5 (95% CI: 5.2, 8.0) per 100 PY of observation. This finding is in line with previous Ethiopian studies conducted in Gondar (7.89 cases per 100 PY) [ 23 ] and Arba Minch (5.36 cases per 100 PY) [ 24 ]. On the other hand, this finding is higher than studies from developed as well as developing countries including: Brazil (2.28 cases per 100 PY) [ 28 ], Nigeria (0.57 cases per 100 PY) [ 29 ] and Tanzania (4.4 cases per 100 PY) [ 30 ]. The higher incidence of TB in this study may be attributed to the differences in follow-up period, sample size, characteristic of study participants, and difference in TB prevalence [ 20 ]. For example, the median follow-up period for a study conducted in Tanzania [30] was two years, whereas, in this study, it was six years. It is well understood that as the follow-up period increases, the number of events also increases. Additional possible explanation for the above variations could be due to the differences in characteristic of study participants. In this regard, a study done in Tanzania included all HIV-positive patients-initiated ART in all health facilities [30]. However, our study was conducted at a referral hospital providing tertiary level services for patients referred from health centers or general hospitals who are often experiencing advanced disease stage and are at higher risk of developing TB [ 31 ]. However, the incidence rate of TB obtained from this study is lower than a study conducted in Afar region, Northeast Ethiopia (8.6 cases per 100 PY) [ 22 ]. This variation could be explained by the difference in study settings, since this study was conducted at one referral hospital, whereas the study conducted in Afar region was done in three hospitals and two health centers. As the Ethiopian TB care strategy currently is decentralized patients commonly visit health centers before referred to hospitals; hence, including health centers as a study stetting will increase the case detection rate, which ultimately increases the incidence of TB [ 22 ]. Another possible explanation for this variation could be due to the difference in characteristics of study participants during ART initiation. In this study, about 38.2% of the study participants were classified as WHO clinical stage III or IV, but, in a study conducted in Afar health facilities, more than half (53.4%) of the study participants were classified as WHO stage III or IV [ 18 ]. As the WHO clinical disease stage becomes more advanced, the risk of OIs developing and recurring including TB simultaneously increases. Regarding the time to develop TB, about 60% of TB cases developed TB in the first six months of follow-up. This finding is in line with studies conducted in different parts of Ethiopia and elsewhere [ 20 , 22-24 , 28-30 ]. The higher incidence of TB in early phase of ART could be associated with the progression of the disease from latent to active TB potentially remaining undetectable during early phase of ART [ 32 ]. Immune reconstitution inflammatory syndrome was very common in the first 2-12 weeks of ART. It highly increases the protective responses of the immune system, which leads to a typical inflammatory condition which creates a higher chance of latent TB infection to become active TB [ 33 ]. Moreover, the main actions of HAART are increasing CD4 cell counts and decreasing viral load, which ultimately improves the immune function and reduces the OIs occurrence including TB [ 34 ]. In this study, advanced WHO clinical disease stage (III and IV) was found to be an important predictor of TB among HIV-positive adults on ART. This finding is consistent with studies previously conducted in different regions of Ethiopia [ 23 , 30 , 31 , 35-37 ], and South Africa [ 32 ]. as WHO clinical disease staging becomes more advanced, the risk of developing and recurrence of OIs including TB simultaneously increased [ 31 ]. Being ambulatory and bedridden was also another predictor of tuberculosis among HIV positive adults. Accordingly, those who were classified as ambulatory and bedridden were more likely to develop TB as compared to those who were classified as working. This finding is consistent with different studies conducted in Ethiopia [ 22 , 23 , 36 ]. Being bedridden and ambulatory functional status are more prone to develop TB because patients become bedridden and ambulatory due to advanced disease stage and more immune compromised stage of HIV [ 23 ]. The other possible explanation could be due to restriction from physical activities and inability to perform daily tasks which, indirectly, compromise the immune system [ 22 ] and may increase the risk of other OIs and TB. In this study, patients who had baseline OIs were more likely to develop TB as compared with those without baseline OIs. This may be due to the presence of OIs during ART initiation will increases piles burden, which resulted from drug-drug interaction and side effects which, resulted synergic effects with HIV. This scenario contributes to further weakening of the immune system [ 32 ]. Moreover, patients who had a low baseline Hgb levels (<10g/dl) were more likely to develop TB as compared to those with normal Hgb levels (≥10g/dl). Supportive findings were reported from previous studies conducted in different regions of Ethiopia [ 22-24 , 36 ]. that the results in these studies found that advancing WHO disease stage presence of anemia also increased as a result of immunosuppression and reduction of bone marrow cell production [ 36 ]. Lastly, taking IPT was another independent predictor of tuberculosis among HIV positive adults on ART. Patients who had not taken IPT were more likely to develop TB as compared to those who took IPT. This finding is congruent with previous studies conducted in different parts of Ethiopia [ 17 , 18 , 22 , 36 ], which may reflect the role of IPT in reducing the occurrence of TB among PLHIV [ 16 , 38 ]. As a result, all HIV positive individuals who have no evidence of active TB infection should be taking IPT to prevent TB infection. Public health implications The results of this study are a critical knowledge input for policy makers and program planners designing various TB control programs. Besides, results obtained from this study will be helpful for health care professionals working in the area of TB/HIV control and prevention unit of Debre Markos Referral Hospital. Additionally, the study provides insights into further intervention studies. Limitations of the study This study has some limitations that must be considered before interpreting results. As the study was conducted through reviewing of records, it did not include important predictors of TB like housing conditions, household incomes, viral loads, and substance use due to incomplete recording system. In addition, study subjects who had incomplete data were excluded from the study. This could undermine or overestimate the incidence of TB. Furthermore, since this study was a facility-based study it does not capture HIV-positive individuals who are out of care (at the community level). The study also focused on adults only; hence, results might not be mirrored in pediatric patient groups. Conclusions The study found a high rate of TB occurrence as compared to previous studies. Baseline OIs, being ambulatory and bedridden, advanced disease stage, low Hgb level, and not taking IPT were predictive of TB. Besides, a high rate of TB occurrence was observed in the first six months of ART follow-up. Therefore, based on our findings, we Suggest emphasis and close follow-up should be given for the first six months of ART follow-up. Moreover, early detection and treatment of OIs like TB should receive special attention. Furthermore, provision of IPT for HIV positive patients should be strengthened. List of abbreviations AIDS: Acquired Immune Deficiency Syndrome, ART: Antiretroviral Therapy, CDC: Centers for Diseases Control and Prevention, CPT: Co-trimoxazole Preventive Therapy, HAART: Highly Active Antiretroviral Therapy, HIV: Human Immunodeficiency Virus, Hgb: Hemoglobin, TB: Tuberculosis, PLHIV: People Living with Human Immunodeficiency Virus, WHO: World Health Organization Declarations Ethics approval and consent to participate Ethical clearance was obtained from an Institutional Review Committee of Debre Markos University, College of Health Science, and Department of Public Health. Besides, a permission letter was also secured from Debre Markos Referral Hospital. As the study was conducted by retrospective reviewing medical records of HIV-positive adults, informed oral or written consent from the participants was not feasible. Therefore, the Institutional Review Committee formally waived consent. To maintain confidentiality, names or unique ART numbers were not included in the data extraction format. Moreover, collected data were not disclosed to anyone other than principal investigators. Consent for publication Not applicable Availability of data and material The data sets used and/or analyzed during the current study are available from the Corresponding author on reasonable request. Competing interests The authors have declared that they have no competing interests. Authors’ contribution BT : conception of the research idea, study design, data collection, analysis and interpretation, and manuscript write-up. GDK , NMA , MWM, YTH, PP, and AA : analysis and interpretation, and manuscript write-up. All authors have read and approved the final manuscript. Funding Not applicable Acknowledgments The authors extended their special thanks for both data collectors and supervisor. The authors also would like to acknowledge Mr. Fasil Wagnew (MSc) for his constructive comments and suggestions. References Frehiwot N, Mizan K, Seble M, Fethia K, Tekalign M, Zelalem T: National guidelines for comprehensive HIV prevention, care and treatment . Addis Ababa: Ministry of Health 2014. Federal Ministry of Health of Ethiopia: Implementation Guideline for TB/HIV Collaborative Activities in Ethiopia available at http://www.who.int/hiv/pub/guidelines/ethiopia.pdf . December 2007. Lawn SD, Meintjes G, McIlleron H, Harries AD, Wood R: Management of HIV-associated tuberculosis in resource-limited settings: a state-of-the-art review . BMC Medicine 2013, 11 (1):253. World Health Organization: Global Tuberculosis Report 2018. Accessed September 2, 2019 available from https://www.who.int/tb/publications/global_report/gtbr2018_main_text_28Feb2019.pdf?ua=1 . 2018. Beauté J, Dara M, Colombani Pd, Ehsani S, Gozalov O, Hovanesyan A, Ködmön C, Molnarova B, Boom M, van der Werf M: Tuberculosis surveillance and monitoring in Europe 2017 . 2017. GLOBAL TUBERCULOSIS REPORT 2016: Country Profiles for 30 high-burden countries; 20 high TB burden countries based on absolute number of incident cases 10 high TB burden countries based on severity of disease burden(incidence per capita) . 2015. Centers for Diseases Control and Prevention: Global HIV & Tuberculosis Ethiopia Country Profile. Available at https://www.cdc.gov/globalhivtb/where-we-work/ethiopia/ethiopia.html . August 29, 2019. World Health Organization: Global Tuberculosis Report 2018. Available at https://www.who.int/tb/publications/global_report/gtbr2018_main_text_28Feb2019.pdf?ua=1 . 2018. Corbett EL, Marston B, Churchyard GJ, De Cock KM: Tuberculosis in sub-Saharan Africa: opportunities, challenges, and change in the era of antiretroviral treatment . The Lancet 2006, 367 (9514):926-937. Gao J, Zheng P, Fu H: Prevalence of TB/HIV co-infection in countries except China: a systematic review and meta-analysis . PLoS One 2013, 8 (5):e64915. Manosuthi W, Wiboonchutikul S, Sungkanuparph S: Integrated therapy for HIV and tuberculosis . AIDS Research and Therapy 2016, 13 (1):22. Muthamia OG, Chege PM: Determinants of Adherence to Anti Retroviral Therapy among Adults Living with HIV in Urban Low Income Settings: A Case of Kayole Division in Nairobi County, Kenya . Survival 2011, 10 :11. Lemos LdA, Feijão AR, Gir E, Galvão MTG: Quality of life aspects of patients with HIV/tuberculosis co-infection . Acta Paulista de Enfermagem 2012, 25 (SPE1):41-47. Karambu S, Matiru V, Kiptoo M, Oundo J: Characterization and factors associated with diarrhoeal diseases caused by enteric bacterial pathogens among children aged five years and below attending Igembe District Hospital, Kenya . The Pan African Medical Journal 2013, 16 :37. Karambu S, Matiru V, Kiptoo M, Oundo J: Characterization and factors associated with diarrhoeal diseases caused by enteric bacterial pathogens among children aged five years and below attending Igembe District Hospital, Kenya . Pan African Medical Journal 2014, 16 (1). Alemu YM, Awoke W, Wilder-Smith A: Determinants for tuberculosis in HIV-infected adults in Northwest Ethiopia: a multicentre case–control study . BMJ Open 2016, 6 (4):e009058. Assebe LF, Reda HL, Wubeneh AD, Lerebo WT, Lambert SM: The effect of isoniazid preventive therapy on incidence of tuberculosis among HIV-infected clients under pre-ART care, Jimma, Ethiopia: a retrospective cohort study . BMC Public Health 2015, 15 (1):346. Dowdy DW, Golub JE, Saraceni V, Moulton LH, Cavalcante SC, Cohn S, Pacheco AG, Chaisson RE, Durovni B: Impact of isoniazid preventive therapy for HIV-infected adults in Rio de Janeiro, Brazil: an epidemiological model . Journal of Acquired Immune Deficiency Syndromes (1999) 2014, 66 (5):552. World Health Organization: The Use of Co-Trimoxazole Prophylaxis for HIV-Related Infections Among Adults, Adolescents and Children . Geneva: WHO Press; 2013. Sterling TR, Lau B, Zhang J, Freeman A, Bosch RJ, Brooks JT, Deeks SG, French A, Gange S, Gebo KA: Risk factors for tuberculosis after highly active antiretroviral therapy initiation in the United States and Canada: implications for tuberculosis screening . Journal of Infectious Diseases 2011, 204 (6):893-901. Kassa A, Teka A, Shewaamare A, Jerene D: Incidence of tuberculosis and early mortality in a large cohort of HIV infected patients receiving antiretroviral therapy in a tertiary hospital in Addis Ababa, Ethiopia . Transactions of the Royal Society of Tropical Medicine and Hygiene 2012, 106 (6):363-370. Ahmed A, Mekonnen D, Kindie M: Incidence and Predictors of Tuberculosis among Adult People Living with HIV/AIDS in Afar Public Health Facilities, Northeast Ethiopia . AIDS 2015, 1 :3-10. Alene KA, Nega A, Taye BW: Incidence and predictors of tuberculosis among adult people living with human immunodeficiency virus at the University of Gondar Referral Hospital, Northwest Ethiopia . BMC Infectious diseases 2013, 13 (1):292. Dalbo M, Tamiso A: Incidence and Predictors of Tuberculosis among HIV/AIDS Infected Patients: A Five-Year Retrospective Follow-Up Study . Advances in Infectious Diseases 2016, 6 (02):70. Federal Democratic Republic of Ethiopia Ministry of Health: National comprehensive Tuberculosis, Leprosy and TB/HIV training manual for Health Care Workers In . Edited by Ababa A; 2016. The Ethiopian Fedral MIinistry of Health: National ART guidlines for prevention, care and treatment . Ministry of health Ethiopia 2017. Ministry of Health E: National Comprehensive HIV Care and Treatment Training for Health care Providers June, 2014. Saraceni V, Durovni B, Cavalcante SC, Cohn S, Pacheco AG, Moulton LH, Chaisson RE, Golub JE: Survival of HIV patients with tuberculosis started on simultaneous or deferred HAART in the THRio cohort, Rio de Janeiro, Brazil . Brazilian Journal of Infectious Diseases 2014, 18 (5):491-495. Pathmanathan I, Dokubo EK, Shiraishi RW, Agolory SG, Auld AF, Onotu D, Odafe S, Dalhatu I, Abiri O, Debem HC: Incidence and predictors of tuberculosis among HIV-infected adults after initiation of antiretroviral therapy in Nigeria, 2004-2012 . PloS one 2017, 12 (3):e0173309. Enju L, MAKUBI A, DRAIN P, SPIEGELMAN D, SANDO D, Nan L, CHALAMILLA G, SUDFELD CR, HERTZMARK E, FAWZI WW: Tuberculosis incidence rate and risk factors among HIV-infected adults with access to antiretroviral therapy in Tanzania . AIDS (London, England) 2015, 29 (11):1391. Melkamu H, Seyoum B, Dessie Y: Determinants of tuberculosis infection among adult HIV positives attending clinical care in western Ethiopia: A case-control study . AIDS research and treatment 2013, 2013 . Lawn SD, Badri M, Wood R: Tuberculosis among HIV-infected patients receiving HAART: long term incidence and risk factors in a South African cohort . Aids 2005, 19 (18):2109-2116. Purohit V, Bora V, Ramdeo R, Rewari B: Immune reconstitution inflammatory syndrome after initiation of antiretroviral therapy for HIV . Journal, Indian Academy of Clinical Medicine 2010, 11 (2). Bonnet MM, Pinoges LL, Varaine FF, Oberhauser BB, DO O'Brien D, Kebede YY, Hewison CC, Zachariah RR, Ferradini LL: Tuberculosis after HAART initiation in HIV-positive patients from five countries with a high tuberculosis burden . Aids 2006, 20 (9):1275-1279. Habtamu Oljira1 MI: Determinants of Active Tuberculosis among HIV-Positive Adults Attending Clinical Care in Ambo general hospital and Gedo hospital, West Shoa Zone, Oromia, Ethiopia (unmatched case-controlstudy), . Journal of Medicine, Physiology and Biophysics August 2015, 33 (ISSN):2422-8427. Kibret KT, Yalew AW, Belaineh BG, Asres MM: Determinant factors associated with occurrence of tuberculosis among adult people living with HIV after antiretroviral treatment initiation in Addis Ababa, Ethiopia: a case control study . PloS one 2013, 8 (5):e64488. Mitku AA, Dessie ZG, Muluneh EK, Workie DL: Prevalence and associated factors of TB/HIV co-infection among HIV Infected patients in Amhara region, Ethiopia . African health sciences 2016, 16 (2):588-595. Ethiopian Public Health Institute (EPHI): Report on National TB/HIV Sentinel Surveillance April 2010 - June 2015,available https://www.ephi.gov.et/images/pictures/Final_National_TB HIV_Sentinel_Surveillance__OCT_20_FE2015_(1)%20(1).pdf . In . ; December 2015. Tables Table 1. Socio-demographic characteristics of patients on chronic HIV care at Debre-Markos Referral Hospital, Northwest Ethiopia Characteristics Frequency Percentage (%) Age 15-24 year 62 12.6 25-34 year 199 40.4 35-44 year 151 30.7 >45 year 80 16.3 Sex Male 228 46.3 Female 264 53.7 Marital status Single 66 13.4 Married 268 54.5 Divorced 126 25.6 Widowed 32 6.5 Religion Orthodox 477 97.0 Others 15 3.0 Educational status No formal education 145 29.5 Primary 115 23.4 Secondary 144 29.3 Tertiary 86 17.4 Not recorded 2 0.4 Occupation Employed 110 22.6 Unemployed 376 77.4 Residence Within catchment area 464 94.3 Out of catchment area 28 5.7 Disclosure status Disclosed 388 78.9 Not disclosed 104 21.1 Family size 3 85 17.3 Table 2. Baseline clinical, Laboratory, ART and other medication related information of HIV patients on chronic HIV care at Debre-Markos Referral Hospital, Northwest Ethiopia Characteristics Frequency (N) Percentage (%) WHO clinical staging I / II 304 61.8 III /IV 188 38.2 CD4 count = 351 115 23.4 Functional status Working 418 85.1 Ambulatory /bed redden 73 14.9 Hemoglobin level =10gm/gl 416 90.4 BMI/MUAC Underweight 145 29.5 Not Underweight 347 70.5 Eligible criteria CD4 cell count 199 40.5 WHO stage 49 10.0 Both 116 23.6 Test & treat 89 18.2 Not recorded 38 7.7 Initial regimen 1d = ZDV-3TC EFV 11 2.2 1c = ZDV-3TC- NVP 36 7.3 1e = TDF-3TC-EFV 423 86.2 1f=TDF-3TF-NVP 15 3.1 Other 6 1.2 Past TB history Yes 7 1.4 No 483 98.6 Table 3. Bi-variable and multivariable Cox-regression analysis to identify the predictors of tuberculosis among HIV positive adults on ART care at Debre-Markos Referral Hospital, Northwest Ethiopia Variables Survival status Event Censored CHR (95%CI) AHR (95%CI) Sex Male 47 181 1.6(1.1 2.5) 1.2(0.8, 2.0) Female 36 228 1 1 CD4 cell count =200 cell/mm 3 28 228 1 1 WHO clinical staging Stage I and II 26 278 1 1 Stage III and IV 57 131 4.0 (2.5, 6.4) 2.1 (1.2, 3.2) ** Functional status Working 51 367 1 1 Ambulatory & bedridden 32 41 5.0 (3.2, 7.8) 1.8 (1.1, 3.1) ** BMI / MUAC Underweight 32 113 1.6(1.1.2.6) 1.3 (0.8, 2.1) Not Underweight 51 296 1 1 Hemoglobin level <10 g/dl 27 20 6.7 (4.2, 10.7) 3.5 (2.1, 5.8) ** ≥10 g/dl 56 383 1 1 Opportunistic infection Yes 51 111 3.7 (2.4,5.7) 2.8 (1.7, 4.4)** No 32 298 1 1 CPT Yes 69 354 1 1 No 14 55 1.6 (0.9, 2.8) 1.4 (0.8, 2.5) IPT Yes 10 169 1 1 No 73 240 4.8 (2.5, 9.3) 3.9 (1.9, 7.6) ** ** Significant predictors Cite Share Download PDF Status: Published Journal Publication published 27 Nov, 2019 Read the published version in BMC Public Health → Version 5 posted Editorial decision: Minor revision 24 Oct, 2019 Editor assigned by journal 22 Oct, 2019 Submission checks completed at journal 21 Oct, 2019 Editor invited by journal 21 Oct, 2019 You are reading this latest preprint version Show more versions Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-2384","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research article","associatedPublications":[],"authors":[{"id":196555,"identity":"857a538d-78e8-44a0-9c0e-bbf67b3eab97","order_by":1,"name":"Belisty Temesgen","email":"","orcid":"","institution":"Debre Markos Referral Hospital","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Belisty","middleName":"","lastName":"Temesgen","suffix":""},{"id":196556,"identity":"7352b3ea-2ed0-4aef-b607-e2d238669a63","order_by":2,"name":"Getiye Dejenu Kibret","email":"","orcid":"","institution":"Debre Markos University","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Getiye","middleName":"Dejenu","lastName":"Kibret","suffix":""},{"id":196557,"identity":"8510fed9-f856-4797-b10a-fdcd5bab8a19","order_by":3,"name":"Nakachew Mekonnen Alamirew","email":"","orcid":"","institution":"Debre Markos University","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Nakachew","middleName":"Mekonnen","lastName":"Alamirew","suffix":""},{"id":196558,"identity":"c3f32631-5c68-4088-aeac-d682caf92efc","order_by":4,"name":"Mamaru Wubale Melkamu","email":"","orcid":"","institution":"Debre Markos Referral Hospital","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Mamaru","middleName":"Wubale","lastName":"Melkamu","suffix":""},{"id":196559,"identity":"5779e01a-c816-4629-8806-20bbd1c388d7","order_by":5,"name":"Yitbarek Tenaw Hibstie","email":"","orcid":"","institution":"Debre Markos Referral Hospital","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Yitbarek","middleName":"Tenaw","lastName":"Hibstie","suffix":""},{"id":196560,"identity":"e0eee594-cd1d-4156-bab3-55a845d04572","order_by":6,"name":"Pammla Petrucka","email":"","orcid":"","institution":"University of Saskatchewan College of Nursing","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Pammla","middleName":"","lastName":"Petrucka","suffix":""},{"id":196561,"identity":"6aa6aedb-99bf-4af2-8aa7-5211a9f564aa","order_by":7,"name":"Animut Alebel","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA3UlEQVRIiWNgGAWjYFACxgYwxc/ffABIScgQqSWBgUFyxrEEkBYeIm0CKjY4kGMAYhLWwj+7uXUz7w8GeYYDZz6/ulFjwcPAfvjoBnxaJO4cbLvNk8Bg2Njcu8065xjQYTxpaTfwWnMjEayFsZnh7DbjHDagFgkeM7xa5KFa7NsYcp4Z5/wjQosBVEtiD0MO8+PcNiK0GAK13JyTJpE8Q+KYGXNunwQPGyG/yN1If3bjjY2N7f7zzY8/53yrk+NnP3wMv/chQAJEsEFIIpTDAfMHUlSPglEwCkbByAEAnEhI9VU8/ZwAAAAASUVORK5CYII=","orcid":"https://orcid.org/0000-0003-2822-2062","institution":"Debre Markos University","correspondingAuthor":true,"submittingAuthor":false,"prefix":"","firstName":"Animut","middleName":"","lastName":"Alebel","suffix":""}],"badges":[],"createdAt":"2019-07-15 15:26:18","currentVersionCode":5,"declarations":"","doi":"10.21203/rs.2.11527/v5","doiUrl":"https://doi.org/10.21203/rs.2.11527/v5","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s12889-019-7912-9","type":"published","date":"2019-11-27T12:00:00+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":139490,"identity":"d87e364d-0e13-4be2-a311-5ff7c952c459","added_by":"auto","created_at":"2019-10-25 17:40:56","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":10546,"visible":true,"origin":"","legend":"The overall Kaplan-Meier survival curve of TB free survival time of HIV-positive adults on ART car at Debre-Markos Referral Hospital, Northwest Ethiopia","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/e632be42-c99e-4702-8af2-8ef137b9593b/v5/1.png"},{"id":139492,"identity":"318d7dde-cd8e-4c5b-a7fe-2c775012de0f","added_by":"auto","created_at":"2019-10-25 17:40:56","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":10869,"visible":true,"origin":"","legend":"Goodness of fit test for Cox-proportional hazard regression model.","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/e632be42-c99e-4702-8af2-8ef137b9593b/v5/2.png"},{"id":13477875,"identity":"6b8592bd-821a-47f0-944a-651eeb7ea1ce","added_by":"auto","created_at":"2021-09-16 21:33:29","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1500025,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-2384/v5/06ba2caf-8ffc-4f77-99d3-2e52bcb6ba8c.pdf"}],"financialInterests":"","formattedTitle":"Incidence and predictors of tuberculosis among HIV-positive adults on antiretroviral therapy at Debre Markos Referral Hospital, Northwest Ethiopia: A retrospective record review","fulltext":[{"header":"Background","content":"\u003cp\u003eTuberculosis (TB) is the leading cause of morbidity and mortality among People Living with Human Immunodeficiency Virus (PLHIV) [\u003ca href=\"#_ENREF_1\"\u003e1\u003c/a\u003e]. PLHIV are 20 \u0026nbsp;times more likely to develop TB as compared to those without HIV [\u003ca href=\"#_ENREF_2\"\u003e2\u003c/a\u003e, \u003ca href=\"#_ENREF_3\"\u003e3\u003c/a\u003e]. In 2017, an estimated 10 million people developed TB with 1.6 million succumbing to the disease, of whom, 9% were PLHIV. In the same year, approximately 300,000 people died due to Acquired Immunodeficiency Syndrome (AIDS)-related TB worldwide, with 72% of these deaths occurring in Africa [\u003ca href=\"#_ENREF_4\"\u003e4\u003c/a\u003e]. Sub-Saharan Africa (SSA) bears the highest (74%) burden of all TB cases [\u003ca href=\"#_ENREF_5\"\u003e5\u003c/a\u003e, \u003ca href=\"#_ENREF_6\"\u003e6\u003c/a\u003e].\u003c/p\u003e\n\u003cp\u003eEthiopia is one of the SSA countries with the highest prevalence of TB/HIV co-infection and ranked seventh among the world\u0026rsquo;s 30 highest TB burden countries. In 2017, according to the Centers for Diseases Control (CDC) and Prevention report, the incidence rate of TB in Ethiopia was 164 cases per 100,000 population including approximately 7% who were PLHIV. In the same year, the mortality rate of TB patients in Ethiopia was 24 per 100,000 population [\u003ca href=\"#_ENREF_7\"\u003e7\u003c/a\u003e, \u003ca href=\"#_ENREF_8\"\u003e8\u003c/a\u003e]. A range of interventions have been implemented at the global and local levels to tackle this challenge. For example, integrated management of TB/HIV co-infection in a single health facility via using a single health care provider to deliver integrated therapy and manage both diseases efficiently. In addition, a scale-up of Antiretroviral Therapy (ART) was introduced aimed to reduce HIV-related morbidity and mortality as well as to increase the survival of HIV-infected patients [\u003ca href=\"#_ENREF_9\"\u003e9-12\u003c/a\u003e].\u003c/p\u003e\n\u003cp\u003eThe Ethiopian government has adapted and implemented different strategies to reduce TB related morbidity and mortality among PLHIV. For example, the Ministry of Health (MOH) decentralized TB/HIV co-infection care services from hospitals to health centers and strengthened referral systems to improve TB care and treatment at the community level [\u003ca href=\"#_ENREF_13\"\u003e13\u003c/a\u003e]. In addition, early initiation of ART and early screening of TB, prior to provision of Isonized Preventive Therapy (IPT) [\u003ca href=\"#_ENREF_14\"\u003e14\u003c/a\u003e, \u003ca href=\"#_ENREF_15\"\u003e15\u003c/a\u003e] and Co-trimoxazole Prophylactic Therapy (CPT), were interventions implemented to reduce the incidence of TB among PLHIV [\u003ca href=\"#_ENREF_16\"\u003e16-20\u003c/a\u003e].\u003c/p\u003e\n\u003cp\u003eAlthough the incidence of TB among HIV-positive adults in Ethiopia has improved due to different interventions, it remains the major cause of death among PLHIV. Previous Ethiopian studies have documented that the incidence of TB among HIV-positive adults ranged from 3.3 per 100 PY of observation in Addis Ababa\u0026nbsp; [\u003ca href=\"#_ENREF_21\"\u003e21\u003c/a\u003e] to 8.6 per 100 PY of observation in Afar Region [\u003ca href=\"#_ENREF_22\"\u003e22\u003c/a\u003e]. Previous Ethiopian-based studies have identified a number of contributing factors to increasing TB occurrence among HIV-positive adults including household family size between three \u0026nbsp;to four individuals, cigarette smoking\u003cstrong\u003e,\u0026nbsp; \u003c/strong\u003enot taking IPT, not taking CPT, low baseline CD4 counts, advanced World Health Organization (WHO) clinical disease stages (Stage II or IV), and having a history of diabetic mellitus [\u003ca href=\"#_ENREF_22\"\u003e22-24\u003c/a\u003e].\u003c/p\u003e\n\u003cp\u003eThe Ethiopian government targeted a reduction of \u0026nbsp;TB related deaths by 90% and TB incidence by 80% by 2030 from \u0026nbsp;2015 levels [\u003ca href=\"#_ENREF_25\"\u003e25\u003c/a\u003e]. To evaluate this ambitious plan, current and up-to-date information related to the occurrence of TB is vital. Therefore, this retrospective record review explored the incidence of TB among HIV-positive adults at Debre Markos Referral Hospital. Results obtained from this study will \u0026nbsp;contribute to evidence for policy makers and program planners working at various levels of TB control programs, as well as\u0026nbsp; informing health care professionals in the areas of TB control and prevention.\u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003e\u003cstrong\u003eStudy design\u003ca name=\"_Toc513851766\"\u003e\u003c/a\u003e\u003ca name=\"_Toc376317247\"\u003e\u003c/a\u003e\u003ca name=\"_Toc376314544\"\u003e\u003c/a\u003e, area, and period\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003ca name=\"_Toc513851767\"\u003e\u003c/a\u003e\u003ca name=\"_Toc376317248\"\u003e\u003c/a\u003e\u003ca name=\"_Toc376314545\"\u003e\u003c/a\u003eA retrospective record review was conducted at Debre Markos Referral Hospital of applicable patient records from between January 1, 2012 and December 31, 2017. \u0026nbsp;Debre Markos Referral Hospital is located in Debre Markos Town, which is located 299 km from Addis Ababa, the capital city of Ethiopia and 265 km from Bahir-Dar, the main city of Amhara Regional State. The hospital serves more than 3.5 million people in East Gojjam Zone and neighboring areas. Apart from other services, the hospital has been providing ART follow-up care services since 2005. In the hospital, the recorded number of HIV-positive people ever started ART was 3,716, of whom, 1, 569 HIV-positive adults started ART care between January 1, 2012 and December 31, 2017.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePopulation\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll HIV-positive adults ever started ART at Debre Markos Referral Hospital and who had at least one month of ART follow-up from January 1, 2012 to December 31, 2017 were the target population for this study. All HIV-positive adults ever started ART from January 1, 2012 to December 31, 2017, however, HIV-positive adults on ART who had TB at the beginning of the follow-up and those who had incomplete baseline data for important variables (i.e., WHO stage, CD4 counts, hemoglobin, (Hgb), IPT, CPT and level of ART adherence) were excluded from the study.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSample size determination and sampling procedures\u0026nbsp;\u0026nbsp; \u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe minimum required sample size for this study was calculated using a sample size determination formula for survival analysis using Stata\u0026trade; Version 13 statistical software by considering CD4 count, functional status, and WHO clinical staging as major exposure variables. It was calculated by considering the following statistical assumptions: two-sided significant level (\u0026alpha;) of 5 %, \u0026nbsp;power 80 %, Z\u003csub\u003ea/2\u003c/sub\u003e=\u0026nbsp; value at 95 % CI =1.96, q\u003csub\u003e1\u003c/sub\u003e: proportion of subjects that are in group 1 (exposed), \u0026nbsp;q\u003csub\u003e0: \u003c/sub\u003eproportion of subjects that are in group 2 (unexposed); 1-q\u003csub\u003e1\u003c/sub\u003e, HR: hazard ratio, and probability of event (E) for functional status were taken from a study conducted at the University of Gondar Teaching Hospital (0.33) [\u003ca href=\"#_ENREF_23\"\u003e23\u003c/a\u003e]. Finally, the calculated sample size for this study was 544. To select the study participants, the records of all HIV-positive adults ever started ART and recorded from January 1, 2012 to December 31, 2017 were sorted. Then, the study participants were selected using a simple random sampling technique through computer-generated numbers. We selected this follow-up period for two reasons: : first, we intended to have a nearest six years of follow-up; and second, to take advantage of \u0026nbsp;standardized ART documentation and reporting formats used during this period.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData collection tool and procedures\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe data extraction tool was prepared from the ART entry and follow-up forms. To ensure data quality, before data collection, the data extraction tool was prepared carefully from a standardized ART intake and follow-up forms. Furthermore, before the beginning of data collection, we verified consistency between data recording systems and the prepared checklist by randomly selecting and completing a few chart reviews which resulted in minor amendments of the data collection tool. Three BSc nurses who have been working in the ART clinic of Debre Markos Referral Hospital collected the data. Two days of training was given for both data collectors and supervisor concerning the data collection tool and collection process. The supervisor and principal investigators performed a strict follow-up and supervision throughout the entire data collection period. The most recent laboratory test results before starting ART were considered as a baseline value. If there were no pre-treatment laboratory test results, obtained at the time of ART initiation, test results done within one month of ART initiation were used as a baseline data. In case of two results obtained within a month, the mean value was computed and taken as a baseline.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003cstrong\u003eVariables of the Study \u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe dependent variable was the time to develop TB.\u003c/p\u003e\n\u003cp\u003eThe predictor variables were:\u003cstrong\u003e Socio-demographic characteristics (\u003c/strong\u003eage, sex, marital status, residence, family size, level of education, and occupation), \u003cstrong\u003eBaseline clinical and laboratory characteristics (\u003c/strong\u003eWHO clinical stage, CD4 cell count, hemoglobin level, history of TB, and history of opportunistic infections (OIs) and body mass index (BMI), and \u003cstrong\u003eART and other medication-related characteristics (\u003c/strong\u003etype ART regimens, regimen change, ART side effects, ART adherence, IPT, and CPT).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eIn this study, the focus was on health care documentation of \u003cstrong\u003ethe \u003c/strong\u003e\u003cstrong\u003eevent (the occurrence of TB) \u003c/strong\u003efor HIV-positive adults in cases where TB developed after ART initiation until the end of the study. This was ascertained by review of patient records.\u003c/p\u003e\n\u003cp\u003eIn this study, the study participants were classified as\u003cstrong\u003e censored\u003c/strong\u003e in either of the following conditions: if lost to follow-up or died before developing TB or if alive at the end of the study, but didn\u0026rsquo;t develop TB and took anti-TB medications. These elements were ascertained by reviewing patient records.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eLost to follow-up \u003c/strong\u003ewas defined as an HIV-positive patient missing an ART appointment for one to three months [\u003ca href=\"#_ENREF_26\"\u003e26\u003c/a\u003e]. \u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAdherence \u003c/strong\u003ewas classified as good, fair, or \u0026nbsp;poor, according to the percentage of drug dosage calculated from a monthly total dose of ART drugs; hence, \u0026nbsp;good \u0026nbsp;was reported if equal to or greater than 95% or \u0026le; 3 dose missing per month, fair if 85-94% or 4-8 dose missing per month, or poor if less than 85% or \u0026ge; 9 dose missing per month [\u003ca href=\"#_ENREF_27\"\u003e27\u003c/a\u003e].\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eLow hemoglobin level\u003c/strong\u003e was defined as Hgb level less than to 10 g/dl.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eOpportunistic infections \u003c/strong\u003ewere diagnosed if HIV-positive adults developed any morbidities after starting ART, as documented by the health care professionals.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData processing and analysis\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eData were entered using EPI-data\u0026trade; Version 4.2, and analyzed using STATA Version 13 statistical software. Patient\u0026rsquo;s follow-up characteristics for continuous data were described in terms of central tendency, dispersion, and frequency distribution for categorical data. At the end of follow-up, the outcome of each study participant was dichotomized into censored or event. The necessary assumption of Cox proportional hazard regression model was checked using Schoenfeld residual and Log-Log plot tests. In addition, the model goodness of fit was assessed using Cox-Snell residual test and model with the least value of Akaike\u0026rsquo;s information criteria selected as the best model. The Kaplan Meier survival curve was used to estimate the TB free survival time of HIV-positive adults on ART. Log rank test was used to compare the survival curves of different categorical explanatory variables. Bi-variable Cox-proportional hazard regression model was used to screen variables for the final model. Variables having p-value \u0026le; 0.25 in the bi-variable analysis were fitted into the multivariable Cox-proportional hazard regression model. Finally, adjusted hazard ratio with its corresponding 95% confidence interval was reported to declare the presence of significant association between the explanatory and outcome variables.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003e\u003cstrong\u003eSocio-demographic characteristics of participants\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAfter removal of fifty-two (52) incomplete records, 492 HIV-positive adult charts were included in the final analysis. The median age of the entire cohort was 33.0 years (IQR: 27, 40 years). More than half (53.6%) of the study participants were female and more than three fourth (78.86%) of the participants disclosed their HIV status (Table 1).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eBaseline clinical, laboratory, ART, and other medication-related information\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003ca name=\"_Toc515286289\"\u003e\u003c/a\u003eClinically, more than half (61.8%) of the study participants were classified as WHO clinical stage I/II. The mean baseline CD4 cell count of the study participants was 252.7 cell /mm\u003csup\u003e3\u003c/sup\u003e (SD: \u0026nbsp;9.5 cell /mm\u003csup\u003e3\u003c/sup\u003e). In addition, the majority (90.43%) of study participants had a Hgb of 10 gm/dl and more. Almost, one-third (32.93%) of the participants had baseline OIs. Regarding functional status, the majority (81.2%) of study participants were classified as working functional status. At baseline, less than one-third (29.47%) of the participants were undernourished (BMI \u0026lt; 18.5). About 5% of the participants had a history of initial regimen change during follow-up. The majority (95.53%) of participants had a history of good adherence. Moreover, the majority (85.98%) of participants took CPT; however, only 36.38% received IPT (Table 2).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eIncidence of Tuberculosis\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eIn this study, a total of 492 study participants were followed for a different period, contributing a cohort of 1285.54 PY of observation. During the follow-up period, 83 (16.9%) of the study participants experienced TB with an overall incidence rate of TB of 6.5 (95% CI: 5.2, 8.0) per 100 PY of observation. A 14.5% TB incidence rate (95% CI: 11.3, 18.7 per 100 PY) was highest in the first year of follow-up, decreasing in subsequent years. The cumulative probability of TB free survival at the end of one year, two, three, four, five and six years were 0.87, 0.84, 0.82, 0.80, 0.79, and 0.78 respectively. The mean TB free survival time of the entire follow up was 60.8 months (95% CI: 58.2, 63.1 months) (Figure 1).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eBi-variable and multivariable Cox-regression analysis\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThrough multivariable Cox-regression analysis, advanced WHO clinical stages (III and IV), baseline OIs, being ambulatory and bedridden, low hemoglobin level (\u0026lt;10g/dl), and not taking IPT were found to be significant predictors of TB. In this study, the hazard of developing TB among HIV-positive adults on ART who were classified as WHO clinical stage III and IV at baseline was 2.1 (95% CI: 1.2, 3.2) times higher as compared to those classified as WHO Stages I and II. Similarly, the hazard of developing TB among HIV-positive adults classified as ambulatory and bedridden at baseline was 1.8 (95% CI: 1.1, 3.1) times higher as compared to those who were classified as working functional status. In addition, the hazard of developing TB among patients who had OIs at baseline was 2.8 times (95% CI: 1.7, 4.4) higher as compare to those who were OIs free at baseline. Furthermore, the hazard of developing TB among patients presenting with Hgb level less than 10g/dl during ART initiation was 3.5 (95%CI: 2.1, 5.8) times higher than \u0026nbsp;those with Hgb \u0026nbsp;levels greater than or equal to 10g/dl. Lastly, HIV-positive adults on ART who did not take IPT were 3.9 (95% CI: 1.9, 7.6) times more likely to develop TB as compared to those who took IPT (Table 3). The goodness of fit for the model was assessed using a Cox-Snell residual test (Figure 2).\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eTuberculosis is a major public health challenge and remains the most commonly diagnosed\u0026nbsp; OI among PLHIV [\u003ca href=\"#_ENREF_3\"\u003e3\u003c/a\u003e]. Therefore, we conducted this retrospective record review to determine the incidence and predictors of TB among HIV-positive adults at Debre Markos Referral Hospital. In this study, the overall incidence of TB among HIV-positive adults at Debre Markos Referral Hospital was 6.5 (95% CI: 5.2, 8.0) per 100 PY of observation. This finding is in line with previous Ethiopian studies conducted in Gondar (7.89 cases per 100 PY) [\u003ca href=\"#_ENREF_23\"\u003e23\u003c/a\u003e] and Arba Minch (5.36 cases per 100 PY) [\u003ca href=\"#_ENREF_24\"\u003e24\u003c/a\u003e]. On the other hand, this finding is higher than studies from developed as well as developing countries including: Brazil (2.28 cases\u0026nbsp; per 100 PY) [\u003ca href=\"#_ENREF_28\"\u003e28\u003c/a\u003e], Nigeria (0.57 cases per 100 PY) [\u003ca href=\"#_ENREF_29\"\u003e29\u003c/a\u003e] and Tanzania (4.4 cases per 100 PY) [\u003ca href=\"#_ENREF_30\"\u003e30\u003c/a\u003e].\u003c/p\u003e\n\u003cp\u003eThe higher incidence of TB in this study may be attributed to the differences in follow-up period, sample size, characteristic of study participants, and difference in TB prevalence [\u003ca href=\"#_ENREF_20\"\u003e20\u003c/a\u003e]. For example, the median follow-up period for a study conducted in Tanzania [30] was two years, whereas, in this study, it was six years. It is well understood that as the follow-up period increases, the number of events also increases. Additional possible explanation for the above variations could be due to the differences in characteristic of study participants. In this regard, a study done in Tanzania included all HIV-positive patients-initiated ART in all health facilities [30]. However, our study was conducted at a referral hospital providing tertiary level services for patients referred from health centers or general hospitals who are often experiencing advanced disease stage and are at higher risk of developing TB [\u003ca href=\"#_ENREF_31\"\u003e31\u003c/a\u003e].\u003c/p\u003e\n\u003cp\u003eHowever, the incidence rate of TB obtained from this study is lower than a study conducted in Afar region, Northeast Ethiopia (8.6 cases per 100 PY) [\u003ca href=\"#_ENREF_22\"\u003e22\u003c/a\u003e]. This variation could be explained by the difference in study settings, since this study was conducted at one referral hospital, whereas the study conducted in Afar region was done in three hospitals and two health centers. As the Ethiopian TB care strategy currently is decentralized patients commonly visit health centers before referred to hospitals; hence, \u0026nbsp;including health centers as a study stetting will increase the case detection rate, which ultimately increases the incidence of TB [\u003ca href=\"#_ENREF_22\"\u003e22\u003c/a\u003e]. Another possible explanation for this variation could be due to the difference in characteristics of study participants during ART initiation. In this study, about 38.2% of the study participants were classified as WHO clinical stage III or IV,\u0026nbsp; but, in a study conducted in Afar health facilities, more than half (53.4%) of the study participants were classified as WHO stage III or IV [\u003ca href=\"#_ENREF_18\"\u003e18\u003c/a\u003e]. As the WHO clinical disease stage becomes more advanced, the risk of OIs developing and recurring including TB simultaneously increases.\u0026nbsp;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eRegarding the time to develop TB, about 60% of TB cases developed TB in the first six months of follow-up. This finding is in line with studies conducted in different parts of Ethiopia and elsewhere [\u003ca href=\"#_ENREF_20\"\u003e20\u003c/a\u003e, \u003ca href=\"#_ENREF_22\"\u003e22-24\u003c/a\u003e, \u003ca href=\"#_ENREF_28\"\u003e28-30\u003c/a\u003e]. The higher incidence of TB in early phase of ART could be associated with the progression of the disease from latent to active TB potentially remaining undetectable during early phase of ART [\u003ca href=\"#_ENREF_32\"\u003e32\u003c/a\u003e]. Immune reconstitution inflammatory syndrome was very common in the first 2-12 weeks of ART. It highly increases the protective responses of the immune system, which leads to a typical inflammatory condition which \u0026nbsp;creates a higher chance of latent TB infection to become active TB [\u003ca href=\"#_ENREF_33\"\u003e33\u003c/a\u003e]. Moreover, the main actions of HAART are increasing CD4 cell counts and decreasing viral load, which ultimately improves the immune function and reduces the OIs occurrence including TB [\u003ca href=\"#_ENREF_34\"\u003e34\u003c/a\u003e].\u003c/p\u003e\n\u003cp\u003eIn this study, advanced WHO clinical disease stage (III and IV) was found to be an important predictor of TB among HIV-positive adults on ART. This finding is consistent with studies previously conducted in different regions of Ethiopia [\u003ca href=\"#_ENREF_23\"\u003e23\u003c/a\u003e, \u003ca href=\"#_ENREF_30\"\u003e30\u003c/a\u003e, \u003ca href=\"#_ENREF_31\"\u003e31\u003c/a\u003e, \u003ca href=\"#_ENREF_35\"\u003e35-37\u003c/a\u003e], and South Africa [\u003ca href=\"#_ENREF_32\"\u003e32\u003c/a\u003e]. as WHO clinical disease staging becomes more advanced, the risk of developing and recurrence of OIs including TB simultaneously increased [\u003ca href=\"#_ENREF_31\"\u003e31\u003c/a\u003e].\u003c/p\u003e\n\u003cp\u003eBeing ambulatory and bedridden was also another predictor of tuberculosis among HIV positive adults. Accordingly, those who were classified as ambulatory and bedridden were more likely to develop TB as compared to those who were classified as working. This finding is consistent with different studies conducted in Ethiopia [\u003ca href=\"#_ENREF_22\"\u003e22\u003c/a\u003e, \u003ca href=\"#_ENREF_23\"\u003e23\u003c/a\u003e, \u003ca href=\"#_ENREF_36\"\u003e36\u003c/a\u003e]. Being bedridden and ambulatory functional status are more prone to develop TB because patients become bedridden and ambulatory due to advanced disease stage and more immune compromised stage of HIV [\u003ca href=\"#_ENREF_23\"\u003e23\u003c/a\u003e]. The other possible explanation could be due to restriction from physical activities\u0026nbsp; and\u0026nbsp; inability \u0026nbsp;to perform daily tasks which, indirectly, compromise the immune system [\u003ca href=\"#_ENREF_22\"\u003e22\u003c/a\u003e] and may increase the risk of other OIs and TB.\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eIn this study, patients who had baseline OIs were more likely to develop TB as compared with those without baseline OIs. This may \u0026nbsp;be due to the presence of OIs during ART initiation will increases piles burden, which resulted from drug-drug interaction and side effects which, resulted synergic effects with HIV. This scenario contributes to further weakening of the immune system [\u003ca href=\"#_ENREF_32\"\u003e32\u003c/a\u003e].\u003c/p\u003e\n\u003cp\u003eMoreover, patients who had a low baseline Hgb levels (\u0026lt;10g/dl) were more likely to develop TB as compared to those with normal Hgb levels (\u0026ge;10g/dl). Supportive findings were reported from previous studies conducted in different regions of Ethiopia [\u003ca href=\"#_ENREF_22\"\u003e22-24\u003c/a\u003e, \u003ca href=\"#_ENREF_36\"\u003e36\u003c/a\u003e]. that the results in these studies found that advancing \u0026nbsp;WHO disease stage presence of anemia also increased as a result of immunosuppression and reduction of bone marrow cell production [\u003ca href=\"#_ENREF_36\"\u003e36\u003c/a\u003e].\u003c/p\u003e\n\u003cp\u003eLastly, taking IPT was another independent predictor of tuberculosis among HIV positive adults on ART. Patients who had not taken IPT were more likely to develop TB as compared to those who took IPT. This finding is congruent with previous studies conducted in different parts of Ethiopia [\u003ca href=\"#_ENREF_17\"\u003e17\u003c/a\u003e, \u003ca href=\"#_ENREF_18\"\u003e18\u003c/a\u003e, \u003ca href=\"#_ENREF_22\"\u003e22\u003c/a\u003e, \u003ca href=\"#_ENREF_36\"\u003e36\u003c/a\u003e], which\u0026nbsp; may reflect the role of IPT in reducing the occurrence of TB among PLHIV [\u003ca href=\"#_ENREF_16\"\u003e16\u003c/a\u003e, \u003ca href=\"#_ENREF_38\"\u003e38\u003c/a\u003e]. As a result, all HIV positive individuals who have no evidence of active TB infection should be taking IPT to prevent TB infection.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePublic health implications \u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe results of this study are a critical knowledge input for policy makers and program planners designing various TB control programs. Besides, results obtained from this study will be helpful for health care professionals working in the area of TB/HIV control and prevention unit of Debre Markos Referral Hospital.\u0026nbsp; Additionally, the study provides insights into further intervention studies.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eLimitations of the study\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThis study has some limitations that must be considered before interpreting results. As the study was conducted through reviewing of records, it did not include important predictors of TB like housing conditions, household incomes, viral loads, and substance use due to incomplete recording system. In addition, study subjects who had incomplete data were excluded from the study. This could undermine or overestimate the incidence of TB. Furthermore, since this study was a facility-based study it does not capture HIV-positive individuals who are out of care (at the community level). The study also focused on adults only; hence, results might not be mirrored in pediatric patient groups.\u003c/p\u003e"},{"header":"Conclusions","content":"\u003cp\u003eThe study found a high rate of TB occurrence as compared to previous studies. Baseline OIs, being ambulatory and bedridden, advanced disease stage, low Hgb level, and not taking IPT were predictive of TB. Besides, a high rate of TB occurrence was observed in the first six months of ART follow-up. Therefore, based on our findings, we Suggest emphasis and close follow-up should be given for the first six months of ART follow-up. Moreover, early detection and treatment of OIs like TB should receive special attention. Furthermore, provision of IPT for HIV positive patients should be strengthened. \u003c/p\u003e"},{"header":"List of abbreviations","content":"\u003cp\u003eAIDS: Acquired Immune Deficiency Syndrome, ART: Antiretroviral Therapy, CDC: Centers for Diseases Control and Prevention, CPT: Co-trimoxazole Preventive Therapy, HAART: Highly Active Antiretroviral Therapy, HIV: Human Immunodeficiency Virus, Hgb: Hemoglobin, TB: Tuberculosis, PLHIV: People Living with Human Immunodeficiency Virus, WHO: World Health Organization\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eEthical clearance was obtained from an Institutional Review Committee of Debre Markos \u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;University, College of Health Science, and Department of Public Health. Besides, a permission letter was also secured from Debre Markos Referral Hospital. As the study was conducted by retrospective reviewing medical records of HIV-positive adults, informed oral or written consent from the participants was not feasible. Therefore, the Institutional Review Committee formally waived consent. To maintain confidentiality, names or unique ART numbers were not included in the data extraction format. Moreover, collected data were not disclosed to anyone other than principal investigators.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and material\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe data sets used and/or analyzed during the current study are available from the Corresponding author on reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors have declared that they have no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026rsquo; contribution\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eBT\u003c/strong\u003e: conception of the research idea, study design, data collection, analysis and interpretation, and manuscript write-up. \u003cstrong\u003eGDK\u003c/strong\u003e, \u003cstrong\u003eNMA\u003c/strong\u003e\u003cstrong\u003e, MWM, YTH, PP,\u003c/strong\u003e and \u003cstrong\u003eAA\u003c/strong\u003e: analysis and interpretation, and manuscript write-up. All authors have read and approved the final manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgments\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors extended their special thanks for both data collectors and supervisor. The authors also would like to acknowledge Mr. Fasil Wagnew (MSc) for his constructive comments and suggestions.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eFrehiwot N, Mizan K, Seble M, Fethia K, Tekalign M, Zelalem T: \u003cstrong\u003eNational guidelines for comprehensive HIV prevention, care and treatment\u003c/strong\u003e. \u003cem\u003eAddis Ababa: Ministry of Health \u003c/em\u003e2014.\u003c/li\u003e\n\u003cli\u003eFederal Ministry of Health of Ethiopia: \u003cstrong\u003eImplementation Guideline for TB/HIV Collaborative Activities in Ethiopia available at \u003c/strong\u003e\u003ca href=\"http://www.who.int/hiv/pub/guidelines/ethiopia.pdf\"\u003e\u003cstrong\u003ehttp://www.who.int/hiv/pub/guidelines/ethiopia.pdf\u003c/strong\u003e\u003c/a\u003e.\u0026nbsp; December 2007.\u003c/li\u003e\n\u003cli\u003eLawn SD, Meintjes G, McIlleron H, Harries AD, Wood R: \u003cstrong\u003eManagement of HIV-associated tuberculosis in resource-limited settings: a state-of-the-art review\u003c/strong\u003e. \u003cem\u003eBMC Medicine \u003c/em\u003e2013, \u003cstrong\u003e11\u003c/strong\u003e(1):253.\u003c/li\u003e\n\u003cli\u003eWorld Health Organization: \u003cstrong\u003eGlobal Tuberculosis Report 2018. \u003c/strong\u003eAccessed September 2, 2019 available from \u003ca href=\"https://www.who.int/tb/publications/global_report/gtbr2018_main_text_28Feb2019.pdf?ua=1\"\u003e\u003cstrong\u003ehttps://www.who.int/tb/publications/global_report/gtbr2018_main_text_28Feb2019.pdf?ua=1\u003c/strong\u003e\u003c/a\u003e. 2018.\u003c/li\u003e\n\u003cli\u003eBeaut\u0026eacute; J, Dara M, Colombani Pd, Ehsani S, Gozalov O, Hovanesyan A, K\u0026ouml;dm\u0026ouml;n C, Molnarova B, Boom M, van der Werf M: \u003cstrong\u003eTuberculosis surveillance and monitoring in Europe 2017\u003c/strong\u003e. 2017.\u003c/li\u003e\n\u003cli\u003eGLOBAL TUBERCULOSIS REPORT 2016: \u003cstrong\u003eCountry Profiles for 30 high-burden countries; 20 high TB burden countries based on absolute number of incident cases 10 high TB burden countries based on severity of disease burden(incidence per capita)\u003c/strong\u003e. 2015.\u003c/li\u003e\n\u003cli\u003eCenters for Diseases Control and Prevention:\u003cstrong\u003e Global HIV \u0026amp; Tuberculosis Ethiopia Country Profile. \u003c/strong\u003eAvailable at \u003ca href=\"https://www.cdc.gov/globalhivtb/where-we-work/ethiopia/ethiopia.html\"\u003ehttps://www.cdc.gov/globalhivtb/where-we-work/ethiopia/ethiopia.html\u003c/a\u003e. August 29, 2019.\u003c/li\u003e\n\u003cli\u003eWorld Health Organization: \u003cstrong\u003eGlobal Tuberculosis Report 2018. \u0026nbsp;\u003c/strong\u003eAvailable at \u003ca href=\"https://www.who.int/tb/publications/global_report/gtbr2018_main_text_28Feb2019.pdf?ua=1\"\u003ehttps://www.who.int/tb/publications/global_report/gtbr2018_main_text_28Feb2019.pdf?ua=1\u003c/a\u003e. 2018.\u003c/li\u003e\n\u003cli\u003eCorbett EL, Marston B, Churchyard GJ, De Cock KM: \u003cstrong\u003eTuberculosis in sub-Saharan Africa: opportunities, challenges, and change in the era of antiretroviral treatment\u003c/strong\u003e. \u003cem\u003eThe Lancet \u003c/em\u003e2006, \u003cstrong\u003e367\u003c/strong\u003e(9514):926-937.\u003c/li\u003e\n\u003cli\u003eGao J, Zheng P, Fu H: \u003cstrong\u003ePrevalence of TB/HIV co-infection in countries except China: a systematic review and meta-analysis\u003c/strong\u003e. \u003cem\u003ePLoS One \u003c/em\u003e2013, \u003cstrong\u003e8\u003c/strong\u003e(5):e64915.\u003c/li\u003e\n\u003cli\u003eManosuthi W, Wiboonchutikul S, Sungkanuparph S: \u003cstrong\u003eIntegrated therapy for HIV and tuberculosis\u003c/strong\u003e. \u003cem\u003eAIDS Research and Therapy \u003c/em\u003e2016, \u003cstrong\u003e13\u003c/strong\u003e(1):22.\u003c/li\u003e\n\u003cli\u003eMuthamia OG, Chege PM: \u003cstrong\u003eDeterminants of Adherence to Anti Retroviral Therapy among Adults Living with HIV in Urban Low Income Settings: A Case of Kayole Division in Nairobi County, Kenya\u003c/strong\u003e. \u003cem\u003eSurvival \u003c/em\u003e2011, \u003cstrong\u003e10\u003c/strong\u003e:11.\u003c/li\u003e\n\u003cli\u003eLemos LdA, Feij\u0026atilde;o AR, Gir E, Galv\u0026atilde;o MTG: \u003cstrong\u003eQuality of life aspects of patients with HIV/tuberculosis co-infection\u003c/strong\u003e. \u003cem\u003eActa Paulista de Enfermagem \u003c/em\u003e2012, \u003cstrong\u003e25\u003c/strong\u003e(SPE1):41-47.\u003c/li\u003e\n\u003cli\u003eKarambu S, Matiru V, Kiptoo M, Oundo J: \u003cstrong\u003eCharacterization and factors associated with diarrhoeal diseases caused by enteric bacterial pathogens among children aged five years and below attending Igembe District Hospital, Kenya\u003c/strong\u003e. \u003cem\u003eThe Pan African Medical Journal \u003c/em\u003e2013, \u003cstrong\u003e16\u003c/strong\u003e:37.\u003c/li\u003e\n\u003cli\u003eKarambu S, Matiru V, Kiptoo M, Oundo J: \u003cstrong\u003eCharacterization and factors associated with diarrhoeal diseases caused by enteric bacterial pathogens among children aged five years and below attending Igembe District Hospital, Kenya\u003c/strong\u003e. \u003cem\u003ePan African Medical Journal \u003c/em\u003e2014, \u003cstrong\u003e16\u003c/strong\u003e(1).\u003c/li\u003e\n\u003cli\u003eAlemu YM, Awoke W, Wilder-Smith A: \u003cstrong\u003eDeterminants for tuberculosis in HIV-infected adults in Northwest Ethiopia: a multicentre case\u0026ndash;control study\u003c/strong\u003e. \u003cem\u003eBMJ Open \u003c/em\u003e2016, \u003cstrong\u003e6\u003c/strong\u003e(4):e009058.\u003c/li\u003e\n\u003cli\u003eAssebe LF, Reda HL, Wubeneh AD, Lerebo WT, Lambert SM: \u003cstrong\u003eThe effect of isoniazid preventive therapy on incidence of tuberculosis among HIV-infected clients under pre-ART care, Jimma, Ethiopia: a retrospective cohort study\u003c/strong\u003e. \u003cem\u003eBMC Public Health \u003c/em\u003e2015, \u003cstrong\u003e15\u003c/strong\u003e(1):346.\u003c/li\u003e\n\u003cli\u003eDowdy DW, Golub JE, Saraceni V, Moulton LH, Cavalcante SC, Cohn S, Pacheco AG, Chaisson RE, Durovni B: \u003cstrong\u003eImpact of isoniazid preventive therapy for HIV-infected adults in Rio de Janeiro, Brazil: an epidemiological model\u003c/strong\u003e. \u003cem\u003eJournal of Acquired Immune Deficiency Syndromes (1999) \u003c/em\u003e2014, \u003cstrong\u003e66\u003c/strong\u003e(5):552.\u003c/li\u003e\n\u003cli\u003eWorld Health Organization: \u003cstrong\u003eThe Use of Co-Trimoxazole Prophylaxis for HIV-Related Infections Among Adults, Adolescents and Children\u003c/strong\u003e. Geneva: WHO Press; 2013.\u003c/li\u003e\n\u003cli\u003eSterling TR, Lau B, Zhang J, Freeman A, Bosch RJ, Brooks JT, Deeks SG, French A, Gange S, Gebo KA: \u003cstrong\u003eRisk factors for tuberculosis after highly active antiretroviral therapy initiation in the United States and Canada: implications for tuberculosis screening\u003c/strong\u003e. \u003cem\u003eJournal of Infectious Diseases \u003c/em\u003e2011, \u003cstrong\u003e204\u003c/strong\u003e(6):893-901.\u003c/li\u003e\n\u003cli\u003eKassa A, Teka A, Shewaamare A, Jerene D: \u003cstrong\u003eIncidence of tuberculosis and early mortality in a large cohort of HIV infected patients receiving antiretroviral therapy in a tertiary hospital in Addis Ababa, Ethiopia\u003c/strong\u003e. \u003cem\u003eTransactions of the Royal Society of Tropical Medicine and Hygiene \u003c/em\u003e2012, \u003cstrong\u003e106\u003c/strong\u003e(6):363-370.\u003c/li\u003e\n\u003cli\u003eAhmed A, Mekonnen D, Kindie M: \u003cstrong\u003eIncidence and Predictors of Tuberculosis among Adult People Living with HIV/AIDS in Afar Public Health Facilities, Northeast Ethiopia\u003c/strong\u003e. \u003cem\u003eAIDS \u003c/em\u003e2015, \u003cstrong\u003e1\u003c/strong\u003e:3-10.\u003c/li\u003e\n\u003cli\u003eAlene KA, Nega A, Taye BW: \u003cstrong\u003eIncidence and predictors of tuberculosis among adult people living with human immunodeficiency virus at the University of Gondar Referral Hospital, Northwest Ethiopia\u003c/strong\u003e. \u003cem\u003eBMC Infectious diseases \u003c/em\u003e2013, \u003cstrong\u003e13\u003c/strong\u003e(1):292.\u003c/li\u003e\n\u003cli\u003eDalbo M, Tamiso A: \u003cstrong\u003eIncidence and Predictors of Tuberculosis among HIV/AIDS Infected Patients: A Five-Year Retrospective Follow-Up Study\u003c/strong\u003e. \u003cem\u003eAdvances in Infectious Diseases \u003c/em\u003e2016, \u003cstrong\u003e6\u003c/strong\u003e(02):70.\u003c/li\u003e\n\u003cli\u003eFederal Democratic Republic of Ethiopia Ministry of Health: \u003cstrong\u003eNational comprehensive Tuberculosis, Leprosy and TB/HIV training manual for Health Care Workers \u003c/strong\u003eIn\u003cem\u003e.\u003c/em\u003e Edited by Ababa A; 2016.\u003c/li\u003e\n\u003cli\u003eThe Ethiopian Fedral MIinistry of Health: \u003cstrong\u003eNational ART guidlines for prevention, care and treatment\u003c/strong\u003e. \u003cem\u003eMinistry of health Ethiopia \u003c/em\u003e2017.\u003c/li\u003e\n\u003cli\u003eMinistry of Health E: \u003cstrong\u003eNational Comprehensive HIV Care and Treatment Training for Health care Providers\u0026nbsp;\u003c/strong\u003eJune, 2014.\u003c/li\u003e\n\u003cli\u003eSaraceni V, Durovni B, Cavalcante SC, Cohn S, Pacheco AG, Moulton LH, Chaisson RE, Golub JE: \u003cstrong\u003eSurvival of HIV patients with tuberculosis started on simultaneous or deferred HAART in the THRio cohort, Rio de Janeiro, Brazil\u003c/strong\u003e. \u003cem\u003eBrazilian Journal of Infectious Diseases \u003c/em\u003e2014, \u003cstrong\u003e18\u003c/strong\u003e(5):491-495.\u003c/li\u003e\n\u003cli\u003ePathmanathan I, Dokubo EK, Shiraishi RW, Agolory SG, Auld AF, Onotu D, Odafe S, Dalhatu I, Abiri O, Debem HC: \u003cstrong\u003eIncidence and predictors of tuberculosis among HIV-infected adults after initiation of antiretroviral therapy in Nigeria, 2004-2012\u003c/strong\u003e. \u003cem\u003ePloS one \u003c/em\u003e2017, \u003cstrong\u003e12\u003c/strong\u003e(3):e0173309.\u003c/li\u003e\n\u003cli\u003eEnju L, MAKUBI A, DRAIN P, SPIEGELMAN D, SANDO D, Nan L, CHALAMILLA G, SUDFELD CR, HERTZMARK E, FAWZI WW: \u003cstrong\u003eTuberculosis incidence rate and risk factors among HIV-infected adults with access to antiretroviral therapy in Tanzania\u003c/strong\u003e. \u003cem\u003eAIDS (London, England) \u003c/em\u003e2015, \u003cstrong\u003e29\u003c/strong\u003e(11):1391.\u003c/li\u003e\n\u003cli\u003eMelkamu H, Seyoum B, Dessie Y: \u003cstrong\u003eDeterminants of tuberculosis infection among adult HIV positives attending clinical care in western Ethiopia: A case-control study\u003c/strong\u003e. \u003cem\u003eAIDS research and treatment \u003c/em\u003e2013, \u003cstrong\u003e2013\u003c/strong\u003e.\u003c/li\u003e\n\u003cli\u003eLawn SD, Badri M, Wood R: \u003cstrong\u003eTuberculosis among HIV-infected patients receiving HAART: long term incidence and risk factors in a South African cohort\u003c/strong\u003e. \u003cem\u003eAids \u003c/em\u003e2005, \u003cstrong\u003e19\u003c/strong\u003e(18):2109-2116.\u003c/li\u003e\n\u003cli\u003ePurohit V, Bora V, Ramdeo R, Rewari B: \u003cstrong\u003eImmune reconstitution inflammatory syndrome after initiation of antiretroviral therapy for HIV\u003c/strong\u003e. \u003cem\u003eJournal, Indian Academy of Clinical Medicine \u003c/em\u003e2010, \u003cstrong\u003e11\u003c/strong\u003e(2).\u003c/li\u003e\n\u003cli\u003eBonnet MM, Pinoges LL, Varaine FF, Oberhauser BB, DO O'Brien D, Kebede YY, Hewison CC, Zachariah RR, Ferradini LL: \u003cstrong\u003eTuberculosis after HAART initiation in HIV-positive patients from five countries with a high tuberculosis burden\u003c/strong\u003e. \u003cem\u003eAids \u003c/em\u003e2006, \u003cstrong\u003e20\u003c/strong\u003e(9):1275-1279.\u003c/li\u003e\n\u003cli\u003eHabtamu Oljira1 MI: \u003cstrong\u003eDeterminants of Active Tuberculosis among HIV-Positive Adults Attending Clinical Care in Ambo general hospital and Gedo hospital, West Shoa Zone, Oromia, Ethiopia (unmatched case-controlstudy),\u003c/strong\u003e. \u003cem\u003eJournal of Medicine, Physiology and Biophysics \u003c/em\u003eAugust 2015, \u003cstrong\u003e33\u003c/strong\u003e(ISSN):2422-8427.\u003c/li\u003e\n\u003cli\u003eKibret KT, Yalew AW, Belaineh BG, Asres MM: \u003cstrong\u003eDeterminant factors associated with occurrence of tuberculosis among adult people living with HIV after antiretroviral treatment initiation in Addis Ababa, Ethiopia: a case control study\u003c/strong\u003e. \u003cem\u003ePloS one \u003c/em\u003e2013, \u003cstrong\u003e8\u003c/strong\u003e(5):e64488.\u003c/li\u003e\n\u003cli\u003eMitku AA, Dessie ZG, Muluneh EK, Workie DL: \u003cstrong\u003ePrevalence and associated factors of TB/HIV co-infection among HIV Infected patients in Amhara region, Ethiopia\u003c/strong\u003e. \u003cem\u003eAfrican health sciences \u003c/em\u003e2016, \u003cstrong\u003e16\u003c/strong\u003e(2):588-595.\u003c/li\u003e\n\u003cli\u003eEthiopian Public Health Institute (EPHI): \u003cstrong\u003eReport on National TB/HIV Sentinel Surveillance April 2010 - June 2015,available \u003c/strong\u003e\u003ca href=\"https://www.ephi.gov.et/images/pictures/Final_National_TB\"\u003e\u003cstrong\u003ehttps://www.ephi.gov.et/images/pictures/Final_National_TB\u003c/strong\u003e\u003c/a\u003e\u003cstrong\u003e HIV_Sentinel_Surveillance__OCT_20_FE2015_(1)%20(1).pdf\u003c/strong\u003e. In\u003cem\u003e.\u003c/em\u003e; December 2015.\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp style=\"text-align: justify; line-height: 200%;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 200%;\"\u003eTable 1.\u003c/span\u003e\u003c/strong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 200%;\"\u003e Socio-demographic characteristics of patients on chronic HIV care at Debre-Markos Referral Hospital, Northwest Ethiopia\u003c/span\u003e\u003c/p\u003e\n\u003ctable style=\"width: 513.0pt; margin-left: -26.1pt; border-collapse: collapse; border: none;\" width=\"684\"\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 3.75in; border-top: solid windowtext 1.5pt; border-left: none; border-bottom: solid windowtext 1.5pt; border-right: none; padding: 0in 5.4pt 0in 5.4pt;\" colspan=\"2\" width=\"360\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cstrong\u003e\u0026nbsp;\u0026nbsp; Characteristics \u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 2.0in; border-top: solid windowtext 1.5pt; border-left: none; border-bottom: solid windowtext 1.5pt; border-right: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"192\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003eFrequency \u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 99.0pt; border-top: solid windowtext 1.5pt; border-left: none; border-bottom: solid windowtext 1.5pt; border-right: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"132\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003ePercentage (%) \u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 10.65pt;\"\u003e\n\u003ctd style=\"width: 112.5pt; border: none; padding: 0in 5.4pt 0in 5.4pt; height: 10.65pt;\" rowspan=\"4\" width=\"150\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003eAge \u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 157.5pt; border: none; padding: 0in 5.4pt 0in 5.4pt; height: 10.65pt;\" width=\"210\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e15-24 year\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 2.0in; border: none; padding: 0in 5.4pt 0in 5.4pt; height: 10.65pt;\" width=\"192\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e62\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; \u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 99.0pt; border: none; padding: 0in 5.4pt 0in 5.4pt; height: 10.65pt;\" width=\"132\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e12.6\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 157.5pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"210\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e25-34 year\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 2.0in; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"192\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e199\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; \u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 99.0pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"132\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e40.4\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 157.5pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"210\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e35-44 year\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 2.0in; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"192\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e151\u0026nbsp;\u0026nbsp; \u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 99.0pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"132\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e30.7\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 8.4pt;\"\u003e\n\u003ctd style=\"width: 157.5pt; border: none; padding: 0in 5.4pt 0in 5.4pt; height: 8.4pt;\" width=\"210\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u0026gt;45 year\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 2.0in; border: none; padding: 0in 5.4pt 0in 5.4pt; height: 8.4pt;\" width=\"192\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e80\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; \u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 99.0pt; border: none; padding: 0in 5.4pt 0in 5.4pt; height: 8.4pt;\" width=\"132\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e16.3\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; \u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 7.5pt;\"\u003e\n\u003ctd style=\"width: 112.5pt; border: none; padding: 0in 5.4pt 0in 5.4pt; height: 7.5pt;\" rowspan=\"2\" width=\"150\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003eSex \u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 157.5pt; border: none; padding: 0in 5.4pt 0in 5.4pt; height: 7.5pt;\" width=\"210\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003eMale\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 2.0in; border: none; padding: 0in 5.4pt 0in 5.4pt; height: 7.5pt;\" width=\"192\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e228\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; \u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 99.0pt; border: none; padding: 0in 5.4pt 0in 5.4pt; height: 7.5pt;\" width=\"132\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e46.3\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; \u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 157.5pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"210\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003eFemale\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 2.0in; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"192\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e264\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; \u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 99.0pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"132\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e53.7\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; \u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 112.5pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" rowspan=\"4\" width=\"150\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cstrong\u003eMarital status \u003c/strong\u003e\u003c/p\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 157.5pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"210\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003eSingle\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 2.0in; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"192\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e66\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; \u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 99.0pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"132\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e13.4\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; \u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 157.5pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"210\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003eMarried\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 2.0in; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"192\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e268\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; \u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 99.0pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"132\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e54.5\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; \u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 157.5pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"210\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003eDivorced\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 2.0in; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"192\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e126\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; \u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 99.0pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"132\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e25.6\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; \u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 157.5pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"210\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003eWidowed\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 2.0in; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"192\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e32\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; \u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 99.0pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"132\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e\u0026nbsp; 6.5\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; \u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 112.5pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" rowspan=\"2\" width=\"150\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003eReligion \u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 157.5pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"210\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003eOrthodox\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 2.0in; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"192\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e477\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; \u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 99.0pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"132\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e97.0\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 157.5pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"210\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003eOthers\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 2.0in; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"192\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e15\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; \u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 99.0pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"132\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e3.0\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; \u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 112.5pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" rowspan=\"5\" width=\"150\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003eEducational status \u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 157.5pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"210\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003eNo formal education\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 2.0in; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"192\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e145\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; \u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 99.0pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"132\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e29.5\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 157.5pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"210\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003ePrimary\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 2.0in; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"192\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e115\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; \u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 99.0pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"132\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e23.4\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; \u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 157.5pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"210\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003eSecondary\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 2.0in; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"192\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e144\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; \u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 99.0pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"132\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e29.3\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; \u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 157.5pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"210\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003eTertiary\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 2.0in; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"192\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e86\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; \u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 99.0pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"132\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e17.4\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; \u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 13.0pt;\"\u003e\n\u003ctd style=\"width: 157.5pt; border: none; padding: 0in 5.4pt 0in 5.4pt; height: 13.0pt;\" width=\"210\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003eNot recorded\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 2.0in; border: none; padding: 0in 5.4pt 0in 5.4pt; height: 13.0pt;\" width=\"192\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e2\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; \u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 99.0pt; border: none; padding: 0in 5.4pt 0in 5.4pt; height: 13.0pt;\" width=\"132\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e\u0026nbsp; 0.4\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; \u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 9.4pt;\"\u003e\n\u003ctd style=\"width: 112.5pt; border: none; padding: 0in 5.4pt 0in 5.4pt; height: 9.4pt;\" rowspan=\"2\" width=\"150\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003eOccupation\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 157.5pt; border: none; padding: 0in 5.4pt 0in 5.4pt; height: 9.4pt;\" width=\"210\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003eEmployed\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 2.0in; border: none; padding: 0in 5.4pt 0in 5.4pt; height: 9.4pt;\" width=\"192\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e110\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; \u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 99.0pt; border: none; padding: 0in 5.4pt 0in 5.4pt; height: 9.4pt;\" width=\"132\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e22.6\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; \u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 10.5pt;\"\u003e\n\u003ctd style=\"width: 157.5pt; border: none; padding: 0in 5.4pt 0in 5.4pt; height: 10.5pt;\" width=\"210\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003eUnemployed\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 2.0in; border: none; padding: 0in 5.4pt 0in 5.4pt; height: 10.5pt;\" width=\"192\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e376\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; \u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 99.0pt; border: none; padding: 0in 5.4pt 0in 5.4pt; height: 10.5pt;\" width=\"132\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e77.4\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 10.5pt;\"\u003e\n\u003ctd style=\"width: 112.5pt; border: none; padding: 0in 5.4pt 0in 5.4pt; height: 10.5pt;\" rowspan=\"2\" width=\"150\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003eResidence\u0026nbsp; \u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 157.5pt; border: none; padding: 0in 5.4pt 0in 5.4pt; height: 10.5pt;\" width=\"210\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003eWithin catchment area\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 2.0in; border: none; padding: 0in 5.4pt 0in 5.4pt; height: 10.5pt;\" width=\"192\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e464\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 99.0pt; border: none; padding: 0in 5.4pt 0in 5.4pt; height: 10.5pt;\" width=\"132\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e94.3\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; \u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 13.5pt;\"\u003e\n\u003ctd style=\"width: 157.5pt; border: none; padding: 0in 5.4pt 0in 5.4pt; height: 13.5pt;\" width=\"210\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003eOut of catchment area\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 2.0in; border: none; padding: 0in 5.4pt 0in 5.4pt; height: 13.5pt;\" width=\"192\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e28\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; \u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 99.0pt; border: none; padding: 0in 5.4pt 0in 5.4pt; height: 13.5pt;\" width=\"132\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e\u0026nbsp; 5.7\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; \u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 7.5pt;\"\u003e\n\u003ctd style=\"width: 112.5pt; border: none; padding: 0in 5.4pt 0in 5.4pt; height: 7.5pt;\" rowspan=\"2\" width=\"150\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003eDisclosure status\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 157.5pt; border: none; padding: 0in 5.4pt 0in 5.4pt; height: 7.5pt;\" width=\"210\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003eDisclosed\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 2.0in; border: none; padding: 0in 5.4pt 0in 5.4pt; height: 7.5pt;\" width=\"192\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e388\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; \u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 99.0pt; border: none; padding: 0in 5.4pt 0in 5.4pt; height: 7.5pt;\" width=\"132\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e78.9\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 6.6pt;\"\u003e\n\u003ctd style=\"width: 157.5pt; border: none; padding: 0in 5.4pt 0in 5.4pt; height: 6.6pt;\" width=\"210\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003eNot disclosed\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 2.0in; border: none; padding: 0in 5.4pt 0in 5.4pt; height: 6.6pt;\" width=\"192\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e104\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; \u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 99.0pt; border: none; padding: 0in 5.4pt 0in 5.4pt; height: 6.6pt;\" width=\"132\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e21.1\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; \u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 9.0pt;\"\u003e\n\u003ctd style=\"width: 112.5pt; border: none; border-bottom: solid windowtext 1.5pt; padding: 0in 5.4pt 0in 5.4pt; height: 9.0pt;\" rowspan=\"2\" width=\"150\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003eFamily size\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 157.5pt; border: none; padding: 0in 5.4pt 0in 5.4pt; height: 9.0pt;\" width=\"210\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u0026lt;=3\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 2.0in; border: none; padding: 0in 5.4pt 0in 5.4pt; height: 9.0pt;\" width=\"192\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e389\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; \u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 99.0pt; border: none; padding: 0in 5.4pt 0in 5.4pt; height: 9.0pt;\" width=\"132\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e82.7\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; \u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 6.15pt;\"\u003e\n\u003ctd style=\"width: 157.5pt; border: none; border-bottom: solid windowtext 1.5pt; padding: 0in 5.4pt 0in 5.4pt; height: 6.15pt;\" width=\"210\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u0026gt;3\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 2.0in; border: none; border-bottom: solid windowtext 1.5pt; padding: 0in 5.4pt 0in 5.4pt; height: 6.15pt;\" width=\"192\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e85\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 99.0pt; border: none; border-bottom: solid windowtext 1.5pt; padding: 0in 5.4pt 0in 5.4pt; height: 6.15pt;\" width=\"132\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e17.3\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; \u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\u003c/br\u003e\u003c/br\u003e\n\u003cp style=\"margin-top: 12.0pt; text-align: justify; line-height: 150%;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003eTable 2.\u003c/span\u003e\u003c/strong\u003e \u003cspan style=\"font-size: 12.0pt; line-height: 150%; color: windowtext;\"\u003eBaseline clinical, Laboratory, ART\u003c/span\u003e \u003cspan style=\"font-size: 12.0pt; line-height: 150%; color: windowtext;\"\u003eand other medication related information of HIV patients on chronic HIV care at Debre-Markos Referral Hospital, Northwest Ethiopia\u003c/span\u003e\u003c/p\u003e\n\u003ctable style=\"margin-left: -17.1pt; border-collapse: collapse; border: none;\" width=\"702\"\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 328.5pt; border-top: solid windowtext 1.5pt; border-left: none; border-bottom: solid windowtext 1.5pt; border-right: none; padding: 0in 5.4pt 0in 5.4pt;\" colspan=\"2\" width=\"438\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cstrong\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; Characteristics \u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 103.5pt; border-top: solid windowtext 1.5pt; border-left: none; border-bottom: solid windowtext 1.5pt; border-right: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"138\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003eFrequency (N)\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 94.5pt; border-top: solid windowtext 1.5pt; border-left: none; border-bottom: solid windowtext 1.5pt; border-right: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"126\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003ePercentage (%) \u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: .25in;\"\u003e\n\u003ctd style=\"width: 171.0pt; border: none; padding: 0in 5.4pt 0in 5.4pt; height: .25in;\" rowspan=\"2\" width=\"228\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cstrong\u003eWHO clinical staging \u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 157.5pt; border: none; padding: 0in 5.4pt 0in 5.4pt; height: .25in;\" width=\"210\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003eI / II\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 103.5pt; border: none; padding: 0in 5.4pt 0in 5.4pt; height: .25in;\" width=\"138\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e304\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; \u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 94.5pt; border: none; padding: 0in 5.4pt 0in 5.4pt; height: .25in;\" width=\"126\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e61.8\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 4.15pt;\"\u003e\n\u003ctd style=\"width: 157.5pt; padding: 0in 5.4pt 0in 5.4pt; height: 4.15pt;\" width=\"210\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003eIII /IV\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 103.5pt; padding: 0in 5.4pt 0in 5.4pt; height: 4.15pt;\" width=\"138\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e188\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 94.5pt; padding: 0in 5.4pt 0in 5.4pt; height: 4.15pt;\" width=\"126\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e38.2\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 19.3pt;\"\u003e\n\u003ctd style=\"width: 171.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 19.3pt;\" rowspan=\"4\" width=\"228\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003eCD4 count \u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 157.5pt; padding: 0in 5.4pt 0in 5.4pt; height: 19.3pt;\" width=\"210\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u0026nbsp;\u0026lt; 100\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 103.5pt; padding: 0in 5.4pt 0in 5.4pt; height: 19.3pt;\" width=\"138\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e113\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 94.5pt; padding: 0in 5.4pt 0in 5.4pt; height: 19.3pt;\" width=\"126\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e23.0\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 9.05pt;\"\u003e\n\u003ctd style=\"width: 157.5pt; padding: 0in 5.4pt 0in 5.4pt; height: 9.05pt;\" width=\"210\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e100-200\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 103.5pt; padding: 0in 5.4pt 0in 5.4pt; height: 9.05pt;\" width=\"138\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e123\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 94.5pt; padding: 0in 5.4pt 0in 5.4pt; height: 9.05pt;\" width=\"126\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e25.1\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 9.05pt;\"\u003e\n\u003ctd style=\"width: 157.5pt; padding: 0in 5.4pt 0in 5.4pt; height: 9.05pt;\" width=\"210\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e201-350\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 103.5pt; padding: 0in 5.4pt 0in 5.4pt; height: 9.05pt;\" width=\"138\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e140\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 94.5pt; padding: 0in 5.4pt 0in 5.4pt; height: 9.05pt;\" width=\"126\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e28.5\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 14.35pt;\"\u003e\n\u003ctd style=\"width: 157.5pt; padding: 0in 5.4pt 0in 5.4pt; height: 14.35pt;\" width=\"210\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u0026gt;= 351\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 103.5pt; padding: 0in 5.4pt 0in 5.4pt; height: 14.35pt;\" width=\"138\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e115\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 94.5pt; padding: 0in 5.4pt 0in 5.4pt; height: 14.35pt;\" width=\"126\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e23.4\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 13.5pt;\"\u003e\n\u003ctd style=\"width: 171.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 13.5pt;\" rowspan=\"2\" width=\"228\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cstrong\u003eFunctional status \u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 157.5pt; padding: 0in 5.4pt 0in 5.4pt; height: 13.5pt;\" width=\"210\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003eWorking\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 103.5pt; padding: 0in 5.4pt 0in 5.4pt; height: 13.5pt;\" width=\"138\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e418\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; \u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 94.5pt; padding: 0in 5.4pt 0in 5.4pt; height: 13.5pt;\" width=\"126\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e85.1\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 157.5pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"210\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003eAmbulatory /bed redden\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 103.5pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"138\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e73\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; \u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 94.5pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"126\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e14.9\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; \u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 11.3pt;\"\u003e\n\u003ctd style=\"width: 171.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 11.3pt;\" rowspan=\"2\" width=\"228\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003eHemoglobin level \u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 157.5pt; padding: 0in 5.4pt 0in 5.4pt; height: 11.3pt;\" width=\"210\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u0026lt; 10gm/dl\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 103.5pt; padding: 0in 5.4pt 0in 5.4pt; height: 11.3pt;\" width=\"138\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e44\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; \u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 94.5pt; padding: 0in 5.4pt 0in 5.4pt; height: 11.3pt;\" width=\"126\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e9.6\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 6.75pt;\"\u003e\n\u003ctd style=\"width: 157.5pt; padding: 0in 5.4pt 0in 5.4pt; height: 6.75pt;\" width=\"210\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u0026gt;=10gm/gl\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 103.5pt; padding: 0in 5.4pt 0in 5.4pt; height: 6.75pt;\" width=\"138\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e416\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; \u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 94.5pt; padding: 0in 5.4pt 0in 5.4pt; height: 6.75pt;\" width=\"126\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e90.4\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; \u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 14.25pt;\"\u003e\n\u003ctd style=\"width: 171.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 14.25pt;\" rowspan=\"2\" width=\"228\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003eBMI/MUAC\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 157.5pt; padding: 0in 5.4pt 0in 5.4pt; height: 14.25pt;\" width=\"210\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003eUnderweight\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 103.5pt; padding: 0in 5.4pt 0in 5.4pt; height: 14.25pt;\" width=\"138\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e145\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; \u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 94.5pt; padding: 0in 5.4pt 0in 5.4pt; height: 14.25pt;\" width=\"126\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e29.5\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 14.85pt;\"\u003e\n\u003ctd style=\"width: 157.5pt; padding: 0in 5.4pt 0in 5.4pt; height: 14.85pt;\" width=\"210\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u0026nbsp;Not Underweight\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 103.5pt; padding: 0in 5.4pt 0in 5.4pt; height: 14.85pt;\" width=\"138\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e347\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; \u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 94.5pt; padding: 0in 5.4pt 0in 5.4pt; height: 14.85pt;\" width=\"126\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e70.5\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; \u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 13.05pt;\"\u003e\n\u003ctd style=\"width: 171.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 13.05pt;\" rowspan=\"5\" width=\"228\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003eEligible criteria \u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 157.5pt; padding: 0in 5.4pt 0in 5.4pt; height: 13.05pt;\" width=\"210\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003eCD4 cell count\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 103.5pt; padding: 0in 5.4pt 0in 5.4pt; height: 13.05pt;\" width=\"138\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e199\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 94.5pt; padding: 0in 5.4pt 0in 5.4pt; height: 13.05pt;\" width=\"126\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e40.5\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 13.05pt;\"\u003e\n\u003ctd style=\"width: 157.5pt; padding: 0in 5.4pt 0in 5.4pt; height: 13.05pt;\" width=\"210\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003eWHO stage\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 103.5pt; padding: 0in 5.4pt 0in 5.4pt; height: 13.05pt;\" width=\"138\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e49\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 94.5pt; padding: 0in 5.4pt 0in 5.4pt; height: 13.05pt;\" width=\"126\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e10.0\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 13.05pt;\"\u003e\n\u003ctd style=\"width: 157.5pt; padding: 0in 5.4pt 0in 5.4pt; height: 13.05pt;\" width=\"210\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003eBoth\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 103.5pt; padding: 0in 5.4pt 0in 5.4pt; height: 13.05pt;\" width=\"138\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e116\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 94.5pt; padding: 0in 5.4pt 0in 5.4pt; height: 13.05pt;\" width=\"126\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e23.6\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 13.05pt;\"\u003e\n\u003ctd style=\"width: 157.5pt; padding: 0in 5.4pt 0in 5.4pt; height: 13.05pt;\" width=\"210\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003eTest \u0026amp; treat\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 103.5pt; padding: 0in 5.4pt 0in 5.4pt; height: 13.05pt;\" width=\"138\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e89\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 94.5pt; padding: 0in 5.4pt 0in 5.4pt; height: 13.05pt;\" width=\"126\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e18.2\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 14.85pt;\"\u003e\n\u003ctd style=\"width: 157.5pt; padding: 0in 5.4pt 0in 5.4pt; height: 14.85pt;\" width=\"210\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003eNot recorded\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 103.5pt; padding: 0in 5.4pt 0in 5.4pt; height: 14.85pt;\" width=\"138\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e38\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 94.5pt; padding: 0in 5.4pt 0in 5.4pt; height: 14.85pt;\" width=\"126\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e\u0026nbsp; 7.7\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 9.0pt;\"\u003e\n\u003ctd style=\"width: 171.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 9.0pt;\" rowspan=\"5\" width=\"228\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%; tab-stops: right 146.7pt;\"\u003e\u003cstrong\u003eInitial regimen \u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 157.5pt; padding: 0in 5.4pt 0in 5.4pt; height: 9.0pt;\" width=\"210\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e1d = ZDV-3TC EFV\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 103.5pt; padding: 0in 5.4pt 0in 5.4pt; height: 9.0pt;\" width=\"138\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e11\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; \u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 94.5pt; padding: 0in 5.4pt 0in 5.4pt; height: 9.0pt;\" width=\"126\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e\u0026nbsp;2.2\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 9.0pt;\"\u003e\n\u003ctd style=\"width: 157.5pt; padding: 0in 5.4pt 0in 5.4pt; height: 9.0pt;\" width=\"210\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e1c = ZDV-3TC- NVP\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 103.5pt; padding: 0in 5.4pt 0in 5.4pt; height: 9.0pt;\" width=\"138\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e36\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 94.5pt; padding: 0in 5.4pt 0in 5.4pt; height: 9.0pt;\" width=\"126\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e\u0026nbsp;7.3\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 9.0pt;\"\u003e\n\u003ctd style=\"width: 157.5pt; padding: 0in 5.4pt 0in 5.4pt; height: 9.0pt;\" width=\"210\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e1e = TDF-3TC-EFV\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 103.5pt; padding: 0in 5.4pt 0in 5.4pt; height: 9.0pt;\" width=\"138\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e423\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 94.5pt; padding: 0in 5.4pt 0in 5.4pt; height: 9.0pt;\" width=\"126\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e86.2\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 15.25pt;\"\u003e\n\u003ctd style=\"width: 157.5pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.25pt;\" width=\"210\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e1f=TDF-3TF-NVP\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 103.5pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.25pt;\" width=\"138\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e15\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 94.5pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.25pt;\" width=\"126\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e\u0026nbsp; 3.1\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 16.6pt;\"\u003e\n\u003ctd style=\"width: 157.5pt; padding: 0in 5.4pt 0in 5.4pt; height: 16.6pt;\" width=\"210\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003eOther\u0026nbsp; \u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 103.5pt; padding: 0in 5.4pt 0in 5.4pt; height: 16.6pt;\" width=\"138\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e6\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 94.5pt; padding: 0in 5.4pt 0in 5.4pt; height: 16.6pt;\" width=\"126\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e\u0026nbsp; 1.2\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 11.25pt;\"\u003e\n\u003ctd style=\"width: 171.0pt; border: none; border-bottom: solid windowtext 1.5pt; padding: 0in 5.4pt 0in 5.4pt; height: 11.25pt;\" rowspan=\"2\" width=\"228\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003ePast TB history \u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 157.5pt; padding: 0in 5.4pt 0in 5.4pt; height: 11.25pt;\" width=\"210\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003eYes \u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 103.5pt; padding: 0in 5.4pt 0in 5.4pt; height: 11.25pt;\" width=\"138\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e7\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; \u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 94.5pt; padding: 0in 5.4pt 0in 5.4pt; height: 11.25pt;\" width=\"126\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e\u0026nbsp;1.4\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 11.25pt;\"\u003e\n\u003ctd style=\"width: 157.5pt; border: none; border-bottom: solid windowtext 1.5pt; padding: 0in 5.4pt 0in 5.4pt; height: 11.25pt;\" width=\"210\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003eNo \u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 103.5pt; border: none; border-bottom: solid windowtext 1.5pt; padding: 0in 5.4pt 0in 5.4pt; height: 11.25pt;\" width=\"138\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e483\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; \u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 94.5pt; border: none; border-bottom: solid windowtext 1.5pt; padding: 0in 5.4pt 0in 5.4pt; height: 11.25pt;\" width=\"126\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e98.6\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; \u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\u003c/br\u003e\u003c/br\u003e\n\u003cp style=\"text-align: justify; line-height: 150%; margin: 12.0pt 0in 12.0pt 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003eTable 3.\u003c/span\u003e\u003c/strong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e Bi-variable and multivariable Cox-regression analysis to identify the predictors of tuberculosis among HIV positive adults on ART care at Debre-Markos Referral Hospital, Northwest Ethiopia\u003c/span\u003e\u003c/p\u003e\n\u003ctable style=\"width: 517.5pt; border-collapse: collapse; border: none;\" width=\"690\"\u003e\n\u003ctbody\u003e\n\u003ctr style=\"height: 26.85pt;\"\u003e\n\u003ctd style=\"width: 177.75pt; border-top: solid windowtext 1.5pt; border-left: none; border-bottom: solid windowtext 1.5pt; border-right: none; padding: 0in 5.4pt 0in 5.4pt; height: 26.85pt;\" width=\"237\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003eVariables\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 1.75in; border-top: solid windowtext 1.5pt; border-left: none; border-bottom: solid windowtext 1.5pt; border-right: none; padding: 0in 5.4pt 0in 5.4pt; height: 26.85pt;\" colspan=\"2\" width=\"168\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%; border: none; padding: 0in;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u0026nbsp; Survival status \u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e\u0026nbsp;Event\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; Censored\u0026nbsp; \u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 105.75pt; border-top: solid windowtext 1.5pt; border-left: none; border-bottom: solid windowtext 1.5pt; border-right: none; padding: 0in 5.4pt 0in 5.4pt; height: 26.85pt;\" width=\"141\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003eCHR (95%CI)\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 1.5in; border-top: solid windowtext 1.5pt; border-left: none; border-bottom: solid windowtext 1.5pt; border-right: none; padding: 0in 5.4pt 0in 5.4pt; height: 26.85pt;\" width=\"144\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003eAHR (95%CI)\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 177.75pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"237\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003eSex \u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 58.5pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"78\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 67.5pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"90\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 105.75pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"141\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 1.5in; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"144\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 177.75pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"237\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp; Male\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 58.5pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"78\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e\u0026nbsp;47 \u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 67.5pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"90\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e181\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; \u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 105.75pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"141\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e1.6(1.1\u0026nbsp;\u0026nbsp;\u0026nbsp; 2.5)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 1.5in; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"144\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e1.2(0.8, 2.0)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 177.75pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"237\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u0026nbsp; Female \u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 58.5pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"78\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e36\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 67.5pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"90\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e228\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 105.75pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"141\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; 1\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 1.5in; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"144\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; 1\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 177.75pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"237\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003eCD4 cell count \u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 58.5pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"78\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 67.5pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"90\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 105.75pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"141\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 1.5in; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"144\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 177.75pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"237\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; \u0026lt;200 cell/mm\u003csup\u003e3\u003c/sup\u003e\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 58.5pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"78\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e55\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 67.5pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"90\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e180\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 105.75pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"141\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e2.2 (1.4, 3.4)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 1.5in; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"144\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e1.3 (0.8, 2.1)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 177.75pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"237\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; \u0026gt;=200 cell/mm\u003csup\u003e3\u003c/sup\u003e\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 58.5pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"78\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e\u0026nbsp;28\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 67.5pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"90\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e228\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 105.75pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"141\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; \u003c/span\u003e\u003c/strong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp;1\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 1.5in; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"144\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; 1\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 177.75pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"237\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003eWHO clinical staging \u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 58.5pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"78\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 67.5pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"90\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 105.75pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"141\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 1.5in; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"144\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 177.75pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"237\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; Stage I and II\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 58.5pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"78\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e\u0026nbsp;26\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 67.5pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"90\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e\u0026nbsp;278\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 105.75pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"141\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; 1\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 1.5in; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"144\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; 1\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 177.75pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"237\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; Stage III and IV\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 58.5pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"78\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e57\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 67.5pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"90\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e131\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 105.75pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"141\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e4.0 (2.5, 6.4)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 1.5in; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"144\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e2.1 (1.2, 3.2)\u003csup\u003e**\u003c/sup\u003e\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 177.75pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"237\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003eFunctional status \u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 58.5pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"78\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 67.5pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"90\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 105.75pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"141\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 1.5in; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"144\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 177.75pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"237\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; Working\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 58.5pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"78\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e51\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 67.5pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"90\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e367\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 105.75pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"141\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; 1 \u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 1.5in; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"144\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; 1\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 177.75pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"237\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; Ambulatory \u0026amp; bedridden\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 58.5pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"78\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e\u0026nbsp;32\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 67.5pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"90\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e41\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 105.75pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"141\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e\u0026nbsp; \u003c/span\u003e\u003c/strong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e5.0 (3.2, 7.8)\u003cstrong\u003e\u0026nbsp;\u0026nbsp; \u003c/strong\u003e\u0026nbsp;\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 1.5in; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"144\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e1.8 (1.1, 3.1)\u003csup\u003e**\u003c/sup\u003e\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 177.75pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"237\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003eBMI / MUAC\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 58.5pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"78\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 67.5pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"90\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 105.75pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"141\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 1.5in; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"144\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 177.75pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"237\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; Underweight\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 58.5pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"78\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e\u0026nbsp;32\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 67.5pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"90\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e\u0026nbsp;113\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 105.75pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"141\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u0026nbsp; 1.6(1.1.2.6)\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; \u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 1.5in; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"144\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e1.3 (0.8, 2.1)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 18.45pt;\"\u003e\n\u003ctd style=\"width: 177.75pt; border: none; padding: 0in 5.4pt 0in 5.4pt; height: 18.45pt;\" width=\"237\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; Not Underweight\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 58.5pt; border: none; padding: 0in 5.4pt 0in 5.4pt; height: 18.45pt;\" width=\"78\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e51\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 67.5pt; border: none; padding: 0in 5.4pt 0in 5.4pt; height: 18.45pt;\" width=\"90\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e296\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 105.75pt; border: none; padding: 0in 5.4pt 0in 5.4pt; height: 18.45pt;\" width=\"141\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; 1\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 1.5in; border: none; padding: 0in 5.4pt 0in 5.4pt; height: 18.45pt;\" width=\"144\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003csup\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp; \u003c/span\u003e\u003c/sup\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;1\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 177.75pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"237\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003eHemoglobin level\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 58.5pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"78\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 67.5pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"90\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 105.75pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"141\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 1.5in; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"144\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 177.75pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"237\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; \u0026lt;10 g/dl\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 58.5pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"78\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e27\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 67.5pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"90\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e20\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 105.75pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"141\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e6.7 (4.2, 10.7)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 1.5in; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"144\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e3.5 (2.1, 5.8)\u003csup\u003e**\u003c/sup\u003e\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 177.75pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"237\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; \u0026ge;10 g/dl\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 58.5pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"78\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e56\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 67.5pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"90\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e383\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 105.75pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"141\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; \u003c/span\u003e\u003c/strong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;1\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 1.5in; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"144\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; \u003c/span\u003e\u003c/strong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e1\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 177.75pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"237\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003eOpportunistic infection \u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 58.5pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"78\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 67.5pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"90\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 105.75pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"141\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 1.5in; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"144\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 177.75pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"237\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u0026nbsp; Yes \u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 58.5pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"78\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e51\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 67.5pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"90\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e111\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 105.75pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"141\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e3.7 (2.4,5.7)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 1.5in; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"144\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e\u0026nbsp; 2.8 (1.7, 4.4)**\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 177.75pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"237\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u0026nbsp; No \u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 58.5pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"78\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e32\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 67.5pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"90\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e298\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 105.75pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"141\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; 1\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 1.5in; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"144\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; 1\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 4.9pt;\"\u003e\n\u003ctd style=\"width: 177.75pt; border: none; padding: 0in 5.4pt 0in 5.4pt; height: 4.9pt;\" width=\"237\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003eCPT\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 58.5pt; border: none; padding: 0in 5.4pt 0in 5.4pt; height: 4.9pt;\" width=\"78\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 67.5pt; border: none; padding: 0in 5.4pt 0in 5.4pt; height: 4.9pt;\" width=\"90\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 105.75pt; border: none; padding: 0in 5.4pt 0in 5.4pt; height: 4.9pt;\" width=\"141\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 1.5in; border: none; padding: 0in 5.4pt 0in 5.4pt; height: 4.9pt;\" width=\"144\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 177.75pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"237\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; Yes \u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 58.5pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"78\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e69\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 67.5pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"90\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e\u0026nbsp;354\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 105.75pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"141\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; \u003c/span\u003e\u003c/strong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e\u0026nbsp;1\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 1.5in; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"144\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp; \u003c/span\u003e\u003c/strong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;1\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 177.75pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"237\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; No \u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 58.5pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"78\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e\u0026nbsp;14\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 67.5pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"90\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e\u0026nbsp;55\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 105.75pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"141\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e1.6 (0.9, 2.8)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 1.5in; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"144\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e1.4 (0.8, 2.5)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 13.9pt;\"\u003e\n\u003ctd style=\"width: 177.75pt; border: none; padding: 0in 5.4pt 0in 5.4pt; height: 13.9pt;\" width=\"237\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003eIPT \u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 58.5pt; border: none; padding: 0in 5.4pt 0in 5.4pt; height: 13.9pt;\" width=\"78\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 67.5pt; border: none; padding: 0in 5.4pt 0in 5.4pt; height: 13.9pt;\" width=\"90\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 105.75pt; border: none; padding: 0in 5.4pt 0in 5.4pt; height: 13.9pt;\" width=\"141\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 1.5in; border: none; padding: 0in 5.4pt 0in 5.4pt; height: 13.9pt;\" width=\"144\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 177.75pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"237\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; Yes \u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 58.5pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"78\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e10\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 67.5pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"90\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e169\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 105.75pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"141\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; \u003c/span\u003e\u003c/strong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e1\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 1.5in; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"144\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; \u003c/span\u003e\u003c/strong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;1\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 177.75pt; border: none; border-bottom: solid windowtext 1.5pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"237\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; No \u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 58.5pt; border: none; border-bottom: solid windowtext 1.5pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"78\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e\u0026nbsp;73\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 67.5pt; border: none; border-bottom: solid windowtext 1.5pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"90\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e240\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 105.75pt; border: none; border-bottom: solid windowtext 1.5pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"141\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e4.8 (2.5, 9.3)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 1.5in; border: none; border-bottom: solid windowtext 1.5pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"144\"\u003e\n\u003cp style=\"text-align: justify; line-height: 150%;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 150%;\"\u003e3.9 (1.9, 7.6)\u003csup\u003e**\u003c/sup\u003e\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp style=\"margin-top: 12.0pt; text-align: justify; line-height: 200%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 200%;\"\u003e** Significant predictors\u003c/span\u003e\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"pubh","sideBox":"Learn more about [BMC Public Health](http://bmcpublichealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/pubh/default.aspx","title":"BMC Public Health","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Debre Markos, HIV, Incidence, Predictors, tuberculosis ","lastPublishedDoi":"10.21203/rs.2.11527/v5","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.2.11527/v5","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"Background: Tuberculosis is the leading cause of morbidity and mortality among people living with human immunodeficiency virus. Almost one-third of deaths among people living with human immunodeficiency virus are attributed to tuberculosis. Despite this evidence, in Ethiopia, there is a scarcity of information regarding the incidence and predictors of tuberculosis among people living with HIV. Thus, this study assessed the incidence and predictors of tuberculosis among HIV-positive adults on antiretroviral therapy. \nMethods: This study was a retrospective record review including 544 HIV-positive adults on antiretroviral therapy at Debre Markos Referral Hospital between January 1, 2012 and December 31, 2017. The study participants were selected using a simple random sampling technique. The data extraction format was adapted from antiretroviral intake and follow-up forms. Cox-proportional hazards regression model was fitted and Cox-Snell residual test was used to assess the goodness of fit. Tuberculosis free survival time was estimated using the Kaplan-Meier survival curve. Both the bi-variable and multivariable Cox-proportional hazard regression models were used to identify predictors of tuberculosis.\nResults: In the final analysis, a total of 492 HIV-positive adults were included, of whom, 83 (16.9%) developed tuberculosis at the time of follow-up. This study found that the incidence of tuberculosis was 6.5 (95% CI: 5.2, 8.0) per 100-person-years (PY) of observation. Advanced World Health Organization clinical disease stage (III and IV) (AHR: 2.1, 95% CI: 1.2, 3.2), being ambulatory and bedridden (AHR: 1.8, 95% CI: 1.1, 3.1), baseline opportunistic infections (AHR: 2.8, 95% CI: 1.7, 4.4), low hemoglobin level (AHR: 3.5, 95% CI: 2.1, 5.8), and not taking Isonized Preventive Therapy (AHR: 3.9, 95% CI: 1.9, 7.6) were found to be the predictors of tuberculosis.\nConclusion: The study found that there was a high rate of tuberculosis occurrence as compared to previous studies. Baseline opportunistic infections, being ambulatory and bedridden, advanced disease stage, low hemoglobin level, and not taking Isonized Preventive Therapy were found to be the predictors of tuberculosis. Therefore, early detection and treatment of opportunistic infections like tuberculosis should get a special attention.\nKeywords: Debre Markos, HIV, Incidence, Predictors, tuberculosis","manuscriptTitle":"Incidence and predictors of tuberculosis among HIV-positive adults on antiretroviral therapy at Debre Markos Referral Hospital, Northwest Ethiopia: A retrospective record review","msid":"","msnumber":"","nonDraftVersions":[{"code":5,"date":"2019-10-25 17:40:56","doi":"10.21203/rs.2.11527/v5","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Minor revision","date":"2019-10-24T12:00:00+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2019-10-22T12:00:00+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2019-10-21T12:00:00+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2019-10-21T12:00:00+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"pubh","sideBox":"Learn more about [BMC Public Health](http://bmcpublichealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/pubh/default.aspx","title":"BMC Public Health","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}},{"code":4,"date":"2019-09-27 20:01:29","doi":"10.21203/rs.2.11527/v4","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Minor revision","date":"2019-10-05T12:00:00+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2019-09-27T12:00:00+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2019-09-26T12:00:00+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2019-09-26T12:00:00+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"pubh","sideBox":"Learn more about [BMC Public Health](http://bmcpublichealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/pubh/default.aspx","title":"BMC Public Health","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}},{"code":3,"date":"2019-09-27 20:00:09","doi":"10.21203/rs.2.11527/v3","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Minor revision","date":"2019-09-18T12:00:00+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2019-09-12T12:00:00+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2019-09-11T12:00:00+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2019-09-11T12:00:00+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"pubh","sideBox":"Learn more about [BMC Public Health](http://bmcpublichealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/pubh/default.aspx","title":"BMC Public Health","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}},{"code":2,"date":"2019-07-31 03:05:48","doi":"10.21203/rs.2.11527/v2","editorialEvents":[{"type":"communityComments","content":0},{"type":"editorInvitedReview","content":"","date":"2019-08-18T12:00:00+00:00","index":2,"fulltext":"Form responses:\n---\n* Does the work include the necessary controls?\nIf not, please specify which controls are required in your comments to the authors.\tYes: **Are the conclusions drawn adequately supported by the data shown?\nIf not, please explain in your comments to the authors.\tYes**\n"},{"type":"decision","content":"Major revision","date":"2019-08-18T12:00:00+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2019-08-16T12:00:00+00:00","index":4,"fulltext":"Form responses:\n---\n* Does the work include the necessary controls?\nIf not, please specify which controls are required in your comments to the authors.\tYes: **Are the conclusions drawn adequately supported by the data shown?\nIf not, please explain in your comments to the authors.\tYes**\n"},{"type":"editorInvitedReview","content":"","date":"2019-08-12T12:00:00+00:00","index":3,"fulltext":"Form responses:\n---\n* Does the work include the necessary controls?\nIf not, please specify which controls are required in your comments to the authors.\tYes: **Are the conclusions drawn adequately supported by the data shown?\nIf not, please explain in your comments to the authors.\tYes**\n"},{"type":"editorInvitedReview","content":"","date":"2019-08-12T12:00:00+00:00","index":1,"fulltext":"Form responses:\n---\n* Does the work include the necessary controls?\nIf not, please specify which controls are required in your comments to the authors.\tYes: **Are the conclusions drawn adequately supported by the data shown?\nIf not, please explain in your comments to the authors.\tYes**\n"},{"type":"reviewerAgreed","content":"","date":"2019-07-30T12:00:00+00:00","index":4,"fulltext":""},{"type":"reviewerAgreed","content":"","date":"2019-07-29T12:00:00+00:00","index":3,"fulltext":""},{"type":"reviewerAgreed","content":"","date":"2019-07-27T12:00:00+00:00","index":2,"fulltext":""},{"type":"reviewerAgreed","content":"","date":"2019-07-26T12:00:00+00:00","index":1,"fulltext":""},{"type":"reviewersInvited","content":"","date":"2019-07-25T12:00:00+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2019-07-23T12:00:00+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2019-07-22T12:00:00+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2019-07-22T12:00:00+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"pubh","sideBox":"Learn more about [BMC Public Health](http://bmcpublichealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/pubh/default.aspx","title":"BMC Public Health","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}},{"code":1,"date":"2019-07-17 19:48:42","doi":"10.21203/rs.2.11527/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revise before sending to peer reviewers","date":"2019-07-19T12:00:00+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2019-07-15T12:00:00+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2019-07-10T12:00:00+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2019-07-09T12:00:00+00:00","index":"","fulltext":""},{"type":"submitted","content":"","date":"2019-07-08T12:00:00+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"pubh","sideBox":"Learn more about [BMC Public Health](http://bmcpublichealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/pubh/default.aspx","title":"BMC Public Health","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"202e422a-cdee-4e70-8435-748a88d31ef5","owner":[],"postedDate":"October 25th, 2019","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[{"id":28897,"name":"Health Policy"}],"tags":[],"updatedAt":"","versionOfRecord":{"articleIdentity":"rs-2384","link":"https://doi.org/10.1186/s12889-019-7912-9","journal":{"identity":"bmc-public-health","isVorOnly":false,"title":"BMC Public Health"},"publishedOn":"2019-11-27 12:00:00","publishedOnDateReadable":"November 27th, 2019"},"versionCreatedAt":"2019-10-25 17:40:56","video":"","vorDoi":"10.1186/s12889-019-7912-9","vorDoiUrl":"https://doi.org/10.1186/s12889-019-7912-9","workflowStages":[]},"version":"v5","identity":"rs-2384","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"identity":"rs-2384","version":["v5"]},"buildId":"ApUGefWb6u5IBVtyqm6d5","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}