Prevalence and predictors of HIV/TB co-infection in Sub-Saharan Africa.

Authors

Abubaker Ibrahim Elbur, Sindhuri Gandla, Raja Nakka, Ruhul Khan, Musie Ghebremichael

Published in

Journal of clinical tuberculosis and other mycobacterial diseases. Volume 45. Pages 100647. Epub Sep 29, 2026.

Abstract

In Sub-Saharan Africa (SSA), tuberculosis is a leading cause of morbidity and mortality among people with HIV (PWH). This study aimed to determine the prevalence of self-reported TB disease and identify the demographic, socioeconomic, and clinical factors associated with it among PWH in SSA.
We conducted a cross-sectional secondary analysis of data from the Population-based HIV Impact Assessment (PHIA) surveys (2015-2019), including PWH aged ≥15 years from 13 countries in the SSA region. TB status was self-reported, and standardized questionnaires and biomarker data provided demographic, socioeconomic, and clinical covariates. Logistic regression models were applied using survey weights and jackknife variance estimation to identify predictors of HIV/TB co-infection.
Among 11,663 participants, 31.5% were people with TB. Co-infection prevalence varied widely by country, ranging from 7.5% in Cameroon to 59.5% in Eswatini, with the highest prevalence observed in Southern African countries. Predictors of increased TB risk include older age [Adjusted (aOR): 1.01; 95% CI: 1.00-1.02; p = 0.012], higher wealth quintile (aOR: 1.09; 95% CI: 1.02-1.16; p < 0.01), and longer ART duration (aOR: 1.41; 95% CI: 1.30-1.52; p < 0.001), while protective factors include female sex (aOR: 0.6; 95% CI: 0.51-0.70; p < 0.001), being married or cohabitating (aOR: 0.81; 95% CI: 0.70-0.96; p = 0.01), urban residence (aOR: 0.82; 95% CI: 0.69-0.98; p = 0.028), and a higher CD4-cell count (aOR: 0.999; 95% CI: 0.998-0.9995; p < 0.001).
HIV/TB co-infection remains highly prevalent in SSA, shaped by demographic, socioeconomic, and clinical factors. Tailored HIV/TB interventions are urgently needed in SSA, prioritizing Southern and Eastern regions and high-risk groups through integrated, community-based, and male-friendly care. Strengthening health systems, improving diagnostics, and addressing social and structural barriers are critical for equitable, sustained progress.

PMID:
42861056
Bibliographic data and abstract were imported from PubMed on 12 Oct 2026.

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