Stunting and its associated factors among children living with HIV/AIDS: a cross-sectional study.

Background: Growth failure is a common feature of children living with HIV/AIDS. This study was intended to assess the level of stunting and its associated factors among children living with HIV/AIDS. Methods: An institution-based cross-sectional study was conducted among 218 children living with HIV/AIDS. An interviewer-administered data collection tools and anthropometric measurements were used to collect data. Bivariable and multivariable logistic regression analyses were used to identify independent variables. Adjusted odds ratio with a 95% CI at a P value of 0.05, which was considered to declare statistical significance. Result: The level of stunting among children infected with HIV/AIDS in selected northwest comprehensive specialized hospitals in western Amhara was 56.9%. Poor anti-retroviral therapy (ART) adherence [adjusted odds ratio (AOR)=6.15, 95% CI, (3.88-9.69)], lack of co-trimoxazole prophylaxis [AOR=2.0, 95% CI, (1.88-2.98)], opportunistic infection [AOR=4.66, 95% CI, (3.24-6.11), and feeding twice [AOR=3.88, 95% CI, (1.94-5.14)] and feeding three times [AOR=1.52, 95% CI, (1.23-3.89)] were significantly associated with stunting. Conclusion: Stunting among HIV/AIDS-infected children was very high. Poor ART adherence, lack of co-trimoxazole prophylaxis, opportunistic infection, and low feeding frequency were significantly associated to stunting among HIV/AIDS-infected children. Strategies need to be devised to address factors amenable to modification to improve the growth of children living with HIV/AIDS.

Epidemiology of streptomycin resistant Salmonella from humans and animals in Ethiopia: A systematic review and meta-analysis.

BACKGROUND: Streptomycin is used as an epidemiological marker in monitoring programs for antimicrobial resistance in Salmonella serovars and indicates the presence of pentaresistance. However, comprehensive data on streptomycin resistant Salmonella among human, animal, and animal products is lacking in Ethiopia. In this review, we aimed to assess heterogeneity and pooled proportion of Salmonella serovars to streptomycin resistance among human, animal and animal products in Ethiopia. METHODS: We conducted a systematic review and meta-analysis of published literature from Ethiopia. We used the MEDLINE/ PubMed, Embase, Cochrane Library, and Google Scholar databases to identify genetic and phenotypic data on Salmonella isolates. To determine the heterogeneity and pooled proportion, we used metaprop commands and the random-effects model. Relative and cumulative frequencies were calculated to describe the overall preponderance of streptomycin resistance isolates after arcsine-transformed data. Metan funnel and meta-bias using a begg test were performed to check for publication bias. RESULTS: Overall, we included 1475 Salmonella serovars in this meta-analysis. The pooled proportion of streptomycin resistance was 47% (95% CI: 35-60%). Sub-group analysis by target population showed that the proportion of streptomycin resistance in Salmonella serovars was 54% (95% CI: 35-73%) in animal, 44% (95% Cl: 33-59%) in humans and 39% (95% CI: 24-55%) in animals products. The streptomycin resistant Salmonella serovars were statistically increasing from 0.35(95% CI: 0.12-0.58) in 2003 to 0.77(95% CI: 0.64-0.89) in 2018. The level of multidrug-resistant (MDR) Salmonella serovars was 50.1% in the meta-analysis. CONCLUSION: We found a high level of streptomycin resistance, including multidrug, Salmonella serovars among human, animals, and animal products. This resistance was significantly increasing in the last three decades (1985-2018). The resistance to streptomycin among Salmonella serovars isolated from animals was higher than humans. This mandates the continuous monitoring of streptomycin use and practicing one health approach to preventing further development of resistance in Ethiopia. REGISTRATION: We conducted a systematic review and meta-analysis after registration of the protocol in PROSPERO (CRD42019135116) following the MOOSE (Meta-Analysis of Observational Studies in Epidemiology).

Undernutrition among Ethiopian adults living with HIV: a meta-analysis.

BACKGROUND: Malnutrition and human immunodeficiency virus (HIV) are interlaced in a vicious cycle and worsened in low and middle-income countries. In Ethiopia, even though individuals are dually affected by both malnutrition and HIV, there is no a nationwide study showing the proportion of malnutrition among HIV-positive adults. Consequently, this review addressed the pooled burden of undernutrition among HIV-positive adults in Ethiopia. METHODS: We searched for potentially relevant studies through manual and electronic searches. An electronic search was carried out using the database of PubMed, Google Scholar, and Google for gray literature and reference lists of previous studies. A standardized data extraction checklist was used to extract the data from each original study. STATA Version 13 statistical software was used for our analysis. Descriptive summaries were presented in tables, and the quantitative result was presented in a forest plot. Heterogeneity within the included studies was examined using the Cochrane Q test statistics and I 2 test. Finally, a random-effects meta-analysis model was computed to estimate the pooled proportion of undernutrition among HIV-positive adults. RESULTS: After reviewing 418 studies, 15 studies met the inclusion criteria and were included in the meta-analysis. Findings from 15 studies revealed that the pooled percentage of undernutrition among HIV-positive adults in Ethiopia was 26% (95% CI: 22, 30%). The highest percentage of undernutrition (46.8%) was reported from Jimma University specialized hospital, whereas the lowest proportion of undernutrition (12.3%) was reported from Dilla Hospital. The subgroup analyses of this study also indicated that the percentage of undernourishment among HIV-positive adults is slightly higher in the Northern and Central parts of Ethiopia (27.5%) as compared to the Southern parts of Ethiopia (25%). CONCLUSION: This study noted that undernutrition among HIV-positive adults in Ethiopia was quite common. This study also revealed that undernutrition is more common among HIV-positive adults with advanced disease stage, anemia, diarrhea, CD4 count less than 200 cells/mm3, and living in rural areas. Based on our findings, we suggested that all HIV-positive adults should be assessed for nutritional status at the time of ART commencement.

Neonatal mortality in the neonatal intensive care unit of Debre Markos referral hospital, Northwest Ethiopia: a prospective cohort study.

BACKGROUND: Neonatal mortality remains a serious global public health problem, but Sub-Saharan Africa (SSA), in particular, is largely affected. Current evidence on neonatal mortality is essential to inform programs and policies, yet there is a scarcity of information concerning neonatal mortality in our study area. Therefore, we conducted this prospective cohort study to determine the incidence and predictors of neonatal mortality at Debre Markos Referral Hospital, Northwest Ethiopia. METHODS: This institutionally-based prospective cohort study was undertaken among 513 neonates admitted to the neonatal intensive care unit of Debre Markos Referral Hospital between December 1st, 2017 and May 30th, 2018. All newborns consecutively admitted to the neonatal intensive care unit during the study period were included. An interviewer administered a questionnaire with the respective mothers. Data were entered using Epi-data™ Version 3.1 and analyzed using STATA™ Version 14. The neonatal survival time was estimated using the Kaplan-Meier survival curve, and the survival time between different categorical variables were compared using the log rank test. Both bi-variable and multivariable Cox-proportional hazard regression models were fitted to identify independent predictors of neonatal mortality. RESULTS: Among a cohort of 513 neonates at Debre Markos Referral Hospital, 109 (21.3%) died during the follow-up time. The overall neonatal mortality rate was 25.8 deaths per 1, 000 neonate-days (95% CI: 21.4, 31.1). In this study, most (83.5%) of the neonatal deaths occurred in the early phase of neonatal period (< 7 days post-partum). Using the multivariable Cox-regression analysis, being unemployed (AHR: 1.6, 95% CI: 1.01, 2.6), not attending ANC (AHR: 1.9, 95% CI: 1.01, 3.5), not initiating exclusive breastfeeding (AHR: 1.7, 95% CI: 1.02, 2.7), neonatal admission due to respiratory distress syndrome (AHR: 2.0, 95% CI: 1.3, 3.1), and first minute Apgar score classification of severe (AHR: 2.1, 95% CI: 1.1, 3.9) significantly increased the risk of neonatal mortality. CONCLUSION: In this study, we found a high rate of early neonatal mortality. Factors significantly linked with increased risk of neonatal mortality included: unemployed mothers, not attending ANC, not initiating exclusive breastfeeding, neonates admitted due to respiratory distress syndrome, and first minute Apgar score classified as severe.

Burden of anemia and its association with HAART in HIV infected children in Ethiopia: a systematic review and meta-analysis.

BACKGROUND: Anemia is a common problem in HIV (human immunodeficiency virus) infected patients, and is associated with decreased functional capacity and quality of life. Ethiopia is one of the countries which has expanded highly active antiretroviral treatment (HAART) over the past years. The effect of HAART on anemia among HIV remains inconsistent and inconclusive, particularly in children. This study thus aimed to synthesize the prevalence of anemia among HIV infected Ethiopian children and its association with HAART initiation. METHODS: MEDLINE/PubMed, EMBASE, PsycINFO, Web of Science and Google scholar were used to identify 12 eligible studies reporting an association between anemia and HIV using a priori set criteria. PRISMA guideline was used to systematically review and meta-analysis these studies. Details of sample size, magnitude of effect sizes, including odds ratio (OR) and standard errors were extracted. Random-effects model was used to calculate the pooled estimates using STATA/SE version-14. I2 and meta-bias statistics assessed heterogeneity and publication bias of the included studies. Sub-group analyses, based on study designs, were also carried out. RESULTS: In Ethiopia, the overall prevalence of anemia in HIV infected children was 22.3% (95% CI: 18.5-26.0%). The OR of anemia-HIV/AIDS comorbidity was 0.4 (95% CI, 0.2-0.5) in HAART initiated children as compared to non-initiated counterparts. Meta-bias and funnel plot detected no publication bias. CONCLUSION: On aggregate, anemia is a common comorbidity in pediatric HIV patients. HAART was significantly associated with a reduced anemia-HIV/AIDS comorbidity. Prompt start of HAART might help decreasing the prevalence of anemia and its subsequent complications.

Prevalence of diabetes mellitus among tuberculosis patients in Sub-Saharan Africa: a systematic review and meta-analysis of observational studies.

BACKGROUND: Tuberculosis and diabetes mellitus are significant global public health challenges. In Sub-Saharan Africa, study findings regarding prevalence of diabetes mellitus amongst tuberculosis patients have been inconsistent and highly variable. Therefore, this systematic review and meta-analysis estimates the overall prevalence of diabetes mellitus among tuberculosis patients in Sub-Saharan Africa. METHODS: Four international databases (PubMed, Google Scholar, Science Direct and Cochrane Library) were systematically searched. We included all observational studies reporting the prevalence of DM among TB patients in Sub-Saharan Africa. All necessary data for this review were extracted using a standardized data extraction format by two authors (CT and AA1). STATA Version 14 statistical software was employed to conduct meta-analysis. The Cochrane Q test statistics and I2 test were used to assess the heterogeneity of the studies. Finally, a random effects meta-analysis model was computed to estimate the pooled prevalence of diabetes mellitus in TB patients. Besides, subgroup analysis was done based on different factors. RESULTS: In the meta-analysis, sixteen studies fulfilled the inclusion criteria and were included. The findings of these 16 studies revealed that the pooled prevalence of diabetes mellitus among tuberculosis patients in Sub-Saharan Africa was 9.0% (95% CI: 6.0, 12.0%). The highest prevalence of diabetes mellitus among tuberculosis patients was found in Nigeria (15%), followed by Tanzania (11%), and then Ethiopia (10%). Besides, the prevalence of diabetes mellitus among HIV infected TB patients was (8.9%) which is slightly higher than HIV uninfected (7.7%) TB patients. CONCLUSION: Diabetes mellitus among tuberculosis patients in Sub-Saharan Africa was significantly high. Moreover, this study found that there was a high prevalence of DM among HIV infected than uninfected TB patients. It is strongly recommended to screen for DM among TB patients and special emphasis should be given for early screening of DM among TB/HIV co-infected patients.

Factors associated with low birth weight at Debre Markos Referral Hospital, Northwest Ethiopia: a hospital based cross-sectional study.

OBJECTIVE: To assess the prevalence and associated factors of low birth weight among newborns delivered at Debre Markos Referral Hospital, Northwest Ethiopia. RESULTS: From the total of 368 newborn baby/mother pairs planned to be participated, 338 agreed and involved in the study giving a response rate of 91.2%. In this study, the prevalence of low birth weight was 21.6 (95% CI 17.5, 26%). Being rural residence (AOR 2.0, 95% CI 1.0, 4.1), duration of pregnancy (AOR = 7.6, 95% CI 3.3, 17.4), and having complications during pregnancy (AOR 2.6, 95% CI 1.2, 5.7) were found to be factors significantly associated with low birth weight.

The effect of antenatal care follow-up on neonatal health outcomes: a systematic review and meta-analysis.

BACKGROUND: Neonatal mortality is one of the major public health problems throughout the world and most notably in developing countries. There exist inconclusive findings on the effect of antenatal care visits on neonatal death worldwide. Thus, the aim of this systematic review and meta-analysis was to reveal the pooled effect of antenatal care visits on neonatal death. METHODS: The present systematic review and meta-analysis was performed using published literature, which was accessed from national and international databases such as, Medline/PubMed, EMBASE, CINAHL, Cochrane Central library, Google Scholar, and HINARI. STATA/SE for windows version 13 software was used to calculate the pooled effect size with 95% confidence intervals (95% CI) of maternal antenatal care visits on neonatal death using the DerSimonian and Laird random effects meta-analysis (random effects model), and results were displayed using forest plot. Statistical heterogeneity was checked using the Cochran Q test (chi-squared statistic) and I 2 test statistic and by visual examination of the forest plot. RESULTS: A total of 18 studies, which fulfilled the inclusion criteria, were included in the present systematic review and meta-analysis. The finding of the present systematic review and meta-analysis revealed that antenatal care visits decrease the risk of neonatal mortality [pooled effect size 0.66 (95% CI, 0.54, 0.80)]. Cochrane Q test (P < 0.001) revealed no significant heterogeneity among included studies, but I 2 statistic revealed sizeable heterogeneity up to 80.5% (I 2 = 80.5%). In the present meta-analysis traditional funnel plot, Egger's weighted regression (P = 0.48) as well as Begg's rank correlation statistic (P = 0.47) revealed no evidence of publication bias. CONCLUSIONS: The present systematic review and meta-analysis revealed that antenatal care visits were significantly associated with lower rates of neonatal death. The risk of neonatal death was significantly reduced by 34% among newborns delivered from mothers who had antenatal care visits. Thus, visiting antenatal care clinics during pregnancy is strongly recommended especially in resource-limited settings like countries of sub-Saharan Africa.

Intimate partner violence and associated factors among pregnant women in Ethiopia: a systematic review and meta-analysis.

BACKGROUND: Intimate Partner Violence (IPV) during pregnancy is a serious public health concern globally. Within Sub-Saharan Africa nearly 40% of women reported abuse by their intimate partners. In Ethiopia, study findings regarding prevalence and associated factors of IPV among pregnant women have been inconsistently reported and highly variable. Thus, this systematic review and meta-analysis estimates the pooled prevalence of IPV and associated factors among pregnant women in Ethiopia. METHODS: International databases (i.e., PubMed, EMBASE, CINAHL, Google Scholar, Science Direct, and the Cochrane Library) were systematically searched during the period of January 1 to February 13, 2018. All identified observational studies reporting the prevalence of IPV and associated factors among pregnant women in Ethiopia were considered. Two authors (AA and CT) independently extracted all necessary data using a standardized data extraction format. Extracted quantitative data were analyzed using STATA Version 13. Heterogeneity among the included studies was assessed through the Cochrane Q test statistics and I2 test. Finally, a random effects meta-analysis model was computed to estimate the pooled prevalence of IPV. Associations between factors and IPV were also examined using a random effects model. RESULTS: After reviewing 605 studies, eight studies involving 2691 pregnant women fulfilled the inclusion criteria and were included in this meta-analysis. The findings of these eight studies revealed that a 26.1% (95% CI: 20, 32.3) overall prevalence of IPV among pregnant women in Ethiopia. The subgroup analysis of this study further revealed the highest observed prevalence was in Oromia region (35%), followed by Amhara region (29%). Mothers'educational status (OR: 2.1, 95% CI: 1.1, 3.7), intimate partners' educational status (OR: 3.5, 95%CI: 1.4, 8.5), and intimate partners' alcohol use (OR: 11.4, 95%CI: 2.3, 56.6) were significantly associated with IPV among pregnant women. CONCLUSION: This study found that the prevalence of IPV among pregnant women in Ethiopia was quite common; with slightly more than 1 in 4, pregnant women experienced IPV during pregnancy. Mothers' educational status, intimate partners' educational status, and intimate partners' alcohol use were factors significantly associated with IPV among pregnant women.

The twin epidemics: Prevalence of TB/HIV co-infection and its associated factors in Ethiopia; A systematic review and meta-analysis.

BACKGROUND: Tuberculosis and HIV/AIDS are the major public health problems in many parts of the world particularly in resource limited countries like Ethiopia. Although studies have been conducted on the prevalence and associated factors of TB / HIV co-infection in Ethiopia, there is no comprehensive data on the magnitude and risk factors at a national and regional levels. Therefore, this review is aimed to summarize the prevalence of TB /HIV co-infection in Ethiopia using meta-analysis based on a systematic review of published articles & grey literatures. METHODS: To conduct this systematic review and meta-analysis, major databases such as Pub Med, Google scholar, CINAHL, Africa Journals Online and Google were systematically searched using search terms. PRISMA guideline was followed in the study. Two authors extracted all necessary data using a standardized data extraction format, and analysis was done using STATA version 11. A Statistical heterogeneity across the studies was evaluated by using Cochran's Q test and I2 statistic. The pooled effect size was conducted in the form of prevalence and associations were measured using odds ratio. Moreover, the univariate meta regression was performed by considering the sample size to determine potential sources of heterogeneity. The Egger's weighted regression and Begg's rank correlation tests were used to assess potential publication biases. RESULTS: This meta-analysis included 21 studies with a total of 12,980 participants. The pooled prevalence of TB / HIV Co-infection was 25.59% (95% CI (20.89%-30.29%). A significant association was found between low CD4 counts (OR: 3.53; 95% CI: 1.55, 8.06), advanced WHO stage (OR: 6.81; 95% CI: 3.91, 11.88) and TB/ HIV/AIDS Co-infection. CONCLUSION: This finding revealed that the magnitude of TB /HIV co-infection in Ethiopia is increasing and deserves special attention. Low CD4 count and advanced WHO stage are contributing factors for dual infection. Establishing mechanisms such as Conducting surveillance to determine HIV burden among TB patients and TB burden among HIV patients, and intensifying the three I's (Intensive case finding, INH Preventive Therapy and Infection control) should be routine work of clinicians. Moreover, early screening & treatment should be provided to those patients with low CD4 count and advanced WHO stage.

Prevalence and determinants of diarrhea among under-five children in Ethiopia: A systematic review and meta-analysis.

BACKGROUND: Despite remarkable progress in the reduction of under-five mortality, childhood diarrhea is still the leading cause of mortality and morbidity in this highly susceptible and vulnerable population. In Ethiopia, study findings regarding prevalence and determinants of diarrhea amongst under-five children have been inconsistent. Therefore, this systematic review and meta-analysis estimates the pooled prevalence of diarrhea and its determinants among under-five children in Ethiopia. METHODS: International databases, including PubMed, Web of Science, EMBASE, CINAHL, Google Scholar, Science Direct, and the Cochrane Library, were systematically searched. All identified observational studies reporting the prevalence and determinants of diarrhea among under-five children in Ethiopia were included. Two authors independently extracted all necessary data using a standardized data extraction format. STATA Version 13 statistical software was used. The Cochrane Q test statistics and I2 test were used to assess the heterogeneity of the studies. A random effects model was computed to estimate the pooled prevalence of diarrhea. Moreover, the associations between determinant factors and childhood diarrhea were examined using the random effect model. RESULTS: After reviewing of 535 studies, 31studies fulfilled the inclusion criteria and were included in the meta-analysis. The findings from the 31 studies revealed that the pooled prevalence of diarrhea among under-five children in Ethiopia was 22% (95%CI: 19, 25%). Subgroup analysis of this study revealed that the highest prevalence was observed in Afar region (27%), followed by Somali and Dire Dawa regions (26%), then Addis Abeba (24%). Lack of maternal education (OR: 2.5, 95% CI: 1.3, 2.1), lack of availability of latrine (OR: 2.0, 95%CI: 1.3, 3.2), urban residence (OR: 1.9, 95%CI: 1.2, 3.0), and maternal hand washing (OR: 2.2, 95%CI: 2.0, 2.6) were significantly associated with childhood diarrhea. CONCLUSION: In this study, diarrhea among under-five children in Ethiopia was significantly high. Lack of maternal education, lack of availability of latrine, urban residence, and lack of maternal hand washing were significantly associated with childhood diarrhea.

Meta-analysis of the prevalence of tuberculosis in diabetic patients and its association with cigarette smoking in African and Asian countries.

OBJECTIVE: This systematic review and meta-analysis was undertaken to estimate the prevalence of tuberculosis in diabetic patients and to determine the effect of cigarette smoking. RESULTS: A total of 15 studies was included in the meta-analysis. The pooled overall prevalence of tuberculosis in diabetes was 4.72% (95% CI 3.62-5.83%). In sub-group analyses, the prevalence was 5.13% (95% CI 4.34-5.92%) in Africa, followed by 4.16% (95% CI 2.9-5.4%) in Asia. The odd ratio of tuberculosis among diabetes patients was 7.6 (95% CI 1.46-39) in cigarette smokers as compared to nonsmokers. Publication bias was detected based on graphic asymmetry of fun-nel plots, Begg's and Egger's tests (p < 0.05). Tuberculosis is a common co-morbidity in diabetic patients. Tuberculosis-diabetes co-morbidity is significantly higher in cigarette smokers.

Effects of undernutrition on survival of human immunodeficiency virus positive children on antiretroviral therapy.

BACKGROUND: The relationship between undernutrition and HIV is bidirectional, ultimately contributing to quality of life and survival of affected individuals. Ethiopia is a sub-Saharan nation influenced by both undernutrition and HIV. In Ethiopia, although individuals are often dually impacted, the effect of undernutrition on the survival of HIV positive children on anti-retroviral therapy (ART) has not been well investigated. Therefore, this study assessed the effect of undernutrition on survival rates of HIV positive children on ART in Amhara Regional State of Ethiopia. METHODS: An institution-based retrospective cohort study was conducted among 390 HIV positive children on ART from the 1st of January, 2012 to the 28th of February, 2017 in Amhara Regional State Referral Hospitals. A simple random sampling technique was used to select the study participants. Data were extracted by reviewing patients' ART intake and follow-up forms. Data were entered into Epi-Data Version 3.1, and analysis was done using STATA Version 13. The Kaplan-Meier survival curve was used to estimate the cumulative survival time of the sample. Log rank tests were employed to compare the survival time between different categories of explanatory variables. Bivariable and multivariable Cox proportional hazards models were fitted to identify predictors of mortality. RESULTS: Among the 390 records included in the final analysis, 9.7% of the individuals died within the follow-up period. In this study, the overall mortality rate was found to be 4.4 per 100 child-years (95% CI: 3.2, 6.0) while undernourished children had a lower survival time than well-nourished children. Low hemoglobin level (AHR: 3.2, 95% CI: 1.4, 7.4), CD4 cell count or percent below the threshold (AHR: 5.2, 95% CI: 1.9, 14.1), severe stunting (AHR: 3.9, 95% CI: 1.7, 9.4), severe wasting (AHR: 3.0, 95% CI: 1.3, 6.9) and advanced disease stage (III and IV) (AHR: 2.6, 95% CI: 1.1, 6.6) were found to be predictors of mortality. CONCLUSION: There was a high rate of mortality. A significant difference was observed in the survival rate of undernourished and well-nourished children. Low hemoglobin level, CD4 count or percent below the threshold, severe wasting, severe stunting, and advanced disease stage were found to be predictors of mortality.

Environmental and host-related determinants of tuberculosis in Metema district, north-west Ethiopia.

BACKGROUND: Each year, one third of the world's population is estimated to be infected with tuberculosis (TB). Globally in 2011, there were an estimated 8.7 million TB cases that resulted in 1.4 million deaths. In Ethiopia, TB is the leading cause of morbidity and the third most common cause of hospital admission. The aim of this study is to assess environmental and host-related determinants of TB in Metema district, north-west Ethiopia. METHODS: A community-based unmatched case-control study was conducted from March 12 to April 5, 2013. The study population included 655 subjects (218 cases and 437 controls in a ratio of 1:2). Cases were TB patients selected from a total of 475 cases registered and treated from March 2012 to February 2013 at the Metema District Hospital DOTS (direct observation therapy, short-course) clinic and selected randomly using a lottery method. Controls were people who had had no productive cough for at least 2 weeks previously and were selected from the community. RESULTS: A total of 655 respondents (218 cases and 437 controls) participated in the study. In multivariate analysis, being illiterate (adjusted odds ratio [AOR] 3.65, 95% confidence interval [CI] 2.31-5.76), households containing more than four family members (AOR 3.09, 95% CI 2.07-4.61), living space <4 m(2) per person (AOR 3.11, 95% CI 2.09-4.63), a nonseparated kitchen (AOR 3.27, 95% CI 1.99-5.35), history of contact with a TB patient (AOR 2.05, 95% CI 1.35-3.12), a house with no ceiling (AOR 1.46, 95% CI 1.07-2.21), and absence of windows (AOR 4.42, 95% CI 2.46-7.95) were independently associated with the development of TB. CONCLUSION: This study identified that the number of family members in the household, educational status, room space per person, history of contact with a TB patient, availability and number of windows, location of kitchen facilities within the house, and whether or not the house had a ceiling were independently associated with contracting TB. Every community should construct houses with the kitchen separated from the main living room, and include a ceiling and more than one window. Cigarette smoking should be avoided since this also contributed to the risk of transmission of TB. Further research focusing on coinfection with human immunodeficiency virus, helminth burden, and malnutrition is important for the control and prevention of TB.