Trends and causes of neonatal mortality from 2010 to 2017 at a Health and Demographic Surveillance site in Northern Ethiopia.

BACKGROUND: Half of global under-five mortalities is neonatal. The highest rates are found in low-income countries such as Ethiopia. Ethiopia has made progress in reducing under-five mortality, but neonatal mortality remains high. Evidence collected continuously at the community level is crucial for understanding the trends and causes of neonatal mortality. OBJECTIVES: To analyse the trends and causes of neonatal mortality at the Kilte-Awlelo Health and Demographic Surveillance System (KAHDSS) site in Ethiopia from 2010 to 2017. METHODS: A descriptive study was conducted using data from neonates born between 2010 and 2017 at the KAHDSS site. Data were collected using interviewer-administered questionnaires. Causes of death were examined, and neonatal mortality trends were described using simple linear regression. RESULTS: The overall average neonatal mortality rate was 17/1000 live births (LBs). The rate increased from 12 per 1000 LBs in 2010 to 15 per 1000 LBs in 2017. The majority of neonatal deaths occurred during the first week of life, and more than one-half died at home. The leading causes were sepsis, pre-term birth (including respiratory distress), disease related to the perinatal period, birth asphyxia, and neonatal pneumonia. CONCLUSIONS: The high neonatal mortality in Ethiopia requires urgent attention and action. Sepsis, preterm birth, perinatal diseases, asphyxia, and neonatal pneumonia are the leading causes of death in neonates. Facility- and community-based health services should target the leading causes of neonatal deaths.

War and Health Care Services Utilization for Chronic Diseases in Rural and Semiurban Areas of Tigray, Ethiopia.

Importance: The war in Tigray, Ethiopia, has disrupted the health care system of the region. However, its association with health care services disruption for chronic diseases has not been well documented. Objective: To assess the association of the war with the utilization of health care services for patients with chronic diseases. Design, Setting, and Participants: Of 135 primary health care facilities, a registry-based cross-sectional study was conducted on 44 rural and semiurban facilities of Tigray. Data on health services utilization were extracted for patients with tuberculosis, HIV, diabetes, hypertension, and psychiatric disorders in the prewar period (September 1, to October 31, 2020) and during the first phase of the war period (November 4, 2020, to June 30, 2021). Main Outcomes and Measures: Records on the number of follow-up, laboratory tests, and patients undergoing treatment of the aforementioned chronic diseases were counted during the prewar and war periods. Results: Of 4645 records of patients with chronic diseases undergoing treatment during the prewar period, 998 records (21%) indicated having treatment during the war period. Compared with the prewar period, 59 of 180 individuals (33%; 95% CI, 26%-40%) had tuberculosis, 522 of 2211 (24%; 95% CI, 22%-26%) had HIV, 228 of 1195 (19%; 95% CI, 17%-21%) had hypertension, 123 of 632 (20%; 95% CI, 16%-22%) had psychiatric disorders, and 66 of 427 (15%; 95% CI, 12%-18%) had type 2 diabetes records, which revealed continued treatment during the war period. Of 174 records of patients with type 1 diabetes in the prewar period, at 2 to 3 months into the war, the numbers dropped to 10 with 94% decline compared with prewar observations. Conclusions and Relevance: This study found that the war in Tigray has resulted in critical health care service disruption and high loss to follow-up for patients with chronic disease, likely leading to increased morbidity and mortality. Local, national, and global policymakers must understand the extent and impact of the service disruption and urge their efforts toward restoration of those services.

War-related sexual and gender-based violence in Tigray, Northern Ethiopia: a community-based study.

INTRODUCTION: Sexual and gender-based violence (SGBV) during armed conflicts has serious ramifications with women and girls disproportionally affected. The impact of the conflict that erupted in November 2020 in Tigray on SGBV is not well documented. This study is aimed at assessing war-related SGBV in war-affected Tigray, Ethiopia. METHODS: A community-based survey was conducted in 52 (out of 84) districts of Tigray, excluding its western zone and some districts bordering Eritrea due to security reasons. Using a two-stage multistage cluster sampling technique, a total of 5171 women of reproductive age (15-49 years) were randomly selected and included in the study. Analysis used weighted descriptive statistics, regression modelling and tests of associations. RESULTS: Overall, 43.3% (2241/5171) of women experienced at least one type of gender-based violence. The incidents of sexual, physical and psychological violence, and rape among women of reproductive age were found to be 9.7% (500/5171), 28.6% (1480/5171), 40.4% (2090/5171) and 7.9% (411/5171), respectively. Of the sexual violence survivors, rape accounted for 82.2% (411/500) cases, of which 68.4% (247) reported being gang raped. Young women (aged 15-24 years) were the most affected by sexual violence, 29.2% (146/500). Commonly reported SGBV-related issues were physical trauma, 23.8% (533/2241), sexually transmitted infections, 16.5% (68/411), HIV infection, 2.7% (11/411), unwanted pregnancy, 9.5% (39/411) and depression 19.2% (431/2241). Most survivors (89.7%) did not receive any postviolence medical or psychological support. CONCLUSIONS: Systemic war-related SGBV was prevalent in Tigray, with gang-rape as the most common form of sexual violence. Immediate medical and psychological care, and long-term rehabilitation and community support for survivors are urgently needed and recommended.

Armed conflict and household food insecurity: evidence from war-torn Tigray, Ethiopia.

BACKGROUND: Exposure to armed conflicts result in strongly adverse and often irreversible short- and long-term effects which may transmit across generations. Armed conflicts directly cause food insecurity and starvation by disruption and destruction of food systems, reduce farming populations, destroying infrastructure, reducing resilience, and increasing vulnerabilities, disruptions in access to market, increasing food price or making goods and services unavailable altogether. The objective of the present study was to determine the status of household food insecurity in the armed conflict affected communities of Tigray in terms of Access, Experience and Hunger scale. METHOD: Community-based cross-sectional study was conducted to assess impact of armed conflict on household food insecurity among households with children with under one year. FHI 360 and FAO guidelines were used to quantify household food insecurity and Household hunger status. RESULTS: Three-fourth of the households had anxiety about food supply and eat undesired monotonous diet due to lack of resources. Households were obliged to eat few kinds of foods, eat smaller meals, eat foods they do not want to eat, or went a whole day without eating any food. Household food insecurity access, food insecurity experience, and hunger scales significantly increased by 43.3 (95% CI: 41.9-44.7), 41.9 (95% CI: 40.5-43.3) and 32.5 (95% CI: 31.0-33.9) percentage points from the prewar period. CONCLUSIONS: Household food insecurity levels and household hunger status of the study communities was unacceptably high. The armed conflict has significant negative effect on food security in Tigray. It is recommended that the study communities need to be protected from the immediate and long-term consequences of conflict-induced household food insecurity.

The impact of war on HIV/AIDS service provision: In rural health facilities of Tigray, northern Ethiopia, a cross-sectional study.

BACK GROUND: HIV/AIDS remained among the common public health problems in developing country. Despite the extensive delivery of ART and improved coverage of the service access, still, man-made problems like war have negatively influenced the utilization of antiretroviral treatment services. The war in Tigray Region in the northern Ethiopia broke out in November 2020 and thereby has brought about an extreme damage on most of the infrastructure in Tigray, including the health institutions. The purpose of this study is, therefore, to assess and report the trend of HIV service provision across the war affected rural health facilities in Tigray. METHODS: The study was conducted in 33 rural health facilities during the active war in Tigray. A facility based retrospective cross-sectional study design was conducted among health facilities from July 03 to August 05, 2021. RESULT: A total of 33 health facilities from 25 rural districts were included in the HIV service delivery assessment. A total of 3274 and 3298 HIV patients were seen during pre-war period in September and October 2020, respectively. The number of follow-up patients during the war period in January remained to be only 847(25%) which is significantly reduced with a P value<0.001. A similar trend was observed during the subsequent months until May. The trend of follow-up patients on ART significantly declined from 1940 in September (pre-war) to 331(16.6%) in May (during the war). This study also revealed a 95.5% reduction of laboratory service provision to HIV/AIDS patients during the war in January and with similar trends thereafter (P<0.001). CONCLUSION: The war has led to a significant decline of HIV service provision in the rural health facilities and most part of the region during the first eight months of active war in Tigray.

A Community-Based Study of Level and Determinants of Substance Use: Findings from Children Experiencing Homelessness in Major Cities of Northern Ethiopia.

Background: Homelessness among children is a significant problem in most nations of the world. Children who experienced homelessness are most often unable to get secured and adequate housing. Such problems expose them to a range of destructive practices such as substance use. This study, therefore, was designed to evaluate the level and determinants of substance use by children who experienced homelessness in major cities of Northern Ethiopia. Methods: This cross-sectional study was undertaken from October 1, 2019 to February 30, 2020. We conducted street-based outreach searching to get a representative sample of the city's children who experienced homelessness and a total of 422 were recruited. The collected data were analyzed using SPSS version 20. Regression analysis was done to identify factors associated with substance use and statistical significance was declared at p < 0.05 and 95% confidence interval. Results: More than 80% of the children who experienced homelessness use alcohol, cigarette or chat. Marriage status of parents before the child experiences homelessness being divorce (AOR = 8.53, 95% CI: 1.87-38.89), occupational status of mother being a daily laborer (AOR = 2.78, 95% CI: 0.83, 9.31), child relationship status with parents before child experiences homelessness (AOR = 0.08, 95% CI: 0.02-0.30) and parents' residential status before child experiences homelessness being rural (AOR = 5.63, 95% CI: 1.77-17.89) are the independent variables that established statistically significant association with the outcome variable, substance use. Conclusion and Recommendation: The majority of the children who experienced homelessness are exposed to substance use, particularly alcohol and cigarette. Efforts are needed by concerned bodies of the region to work on factors that predispose to homelessness and strategically safeguard the health and wellbeing of the children.

Risk factors for mortality among hospitalized COVID-19 patients in Northern Ethiopia: A retrospective analysis.

BACKGROUND: COVID-19 is a deadly pandemic caused by an RNA virus that belongs to the family of CORONA virus. To counter the COVID-19 pandemic in resource limited settings, it is essential to identify the risk factors of COVID-19 mortality. This study was conducted to identify the social and clinical determinants of mortality in COVID-19 patients hospitalized in four treatment centers of Tigray, Northern Ethiopia. METHODS: We reviewed data from 6,637 COVID-19 positive cases that were reported from May 7, 2020 to October 28, 2020. Among these, 925 were admitted to the treatment centers because of their severity and retrospectively analyzed. The data were entered into STATA 16 version for analysis. The descriptive analysis such as median, interquartile range, frequency distribution and percentage were used. Binary logistic regression model was fitted to identify the potential risk factors of mortality of COVID-19 patients. The adjusted odds ratio (AOR) with 95% confidence interval was used to determine the magnitude of the association between the outcome and predictor variables. RESULTS: The median age of the patients was 30 years (IQR, 25-44) and about 70% were male patients. The patients in the non-survivor group were much older than those in the survivor group (median 57.5 years versus 30 years, p-value < 0.001). The overall case fatality rate was 6.1% (95% CI: 4.5% - 7.6%) and was increased to 40.3% (95% CI: 32.2% - 48.4%) among patients with critical and severe illness. The proportions of severe and critical illness in the non-survivor group were significantly higher than those in the survivor group (19.6% versus 5.1% for severe illness and 80.4% versus 4.5% for critical illness, all p-value < 0.001). One or more pre-existing comorbidities were present in 12.5% of the patients: cardiovascular diseases (42.2%), diabetes mellitus (25.0%) and respiratory diseases (16.4%) being the most common comorbidities. The comorbidity rate in the non-survivor group (44.6%) was higher than in the survivor group (10.5%). The results from the multivariable binary regression showed that the odds of mortality was higher for patients who had cardiovascular diseases (AOR = 2.49, 95% CI: 1.03-6.03), shortness of breath (AOR = 9.71, 95% CI: 4.73-19.93) and body weakness (AOR = 3.04, 95% CI: 1.50-6.18). Moreover, the estimated odds of mortality significantly increased with patient's age. CONCLUSIONS: Age, cardiovascular diseases, shortness of breath and body weakness were the predictors for mortality of COVID-19 patients. Knowledge of these could lead to better identification of high risk COVID-19 patients and thus allow prioritization to prevent mortality.

Time to Recovery of Severely Ill COVID-19 Patients and its Predictors: A Retrospective Cohort Study in Tigray, Ethiopia.

Background: COVID-19 is one of the leading causes of morbidity and mortality and is caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). A patient infected with SARS-CoV-2 is said to be recovered from the infection following negative test results and when signs and symptoms disappear. Different studies have shown different median recovery time of patients with COVID-19 and it varies across settings and disease status. This study aimed to assess time to recovery and its predictors among severely ill COVID-19 patients in Tigray. Methods: A total of 139 severely ill COVID-19 patients who were hospitalized between May 7, 2020 and October 28, 2020 were retrospectively analyzed. Cox proportional hazard regression model was fitted to identify the risk factors associated with the time duration to recovery from severe COVID-19 illness. Results: The median age of the patients was 35 years (IQR, 27-60). Eighty-three (59.7%) patients recovered with a median time of 26 days (95% CI: 23-27). The results from the multivariable analysis showed that the recovery time was lower for severely ill patients who had no underline comorbidity diseases (AHR=2.48, 95% CI: 1.18-5.24), shortness of breath (AHR=2.08, 95% CI: 1.07-3.98) and body weakness (AHR=2.62, 95% CI: 1.20-5.72). Moreover, COVID-19 patients aged younger than 40 years had lower recovery time compared to patients aged 60 and above (AHR=4.09, 95% CI: 1.58-10.61). Conclusion: The median recovery time of severely ill COVID-19 patients was long, and older age, comorbidity, shortness of breath, and body weakness were significant factors related with the time to recovery among the severely ill COVID-19 patients. Therefore, we recommended that elders and individuals with at least one comorbidity disease have to get due attention to prevent infection by the virus. Moreover, attention should be given in the treatment practice for individuals who had shortness of breath and body weakness symptoms.

Contraceptive use and its determinants among adolescent women in Tigray, Ethiopia: a multilevel modeling.

BACKGROUND: Adolescent women are central for intergenerational health of human populations. Adolescent women are the most vulnerable to a range of reproductive health problems. One of the leading causes of death for adolescent women is complications from childbirth and pregnancy. Contraceptive prevents the occurrence of unwanted pregnancies and its complications, thus potentially lower the death rate for adolescent women. However, contraceptive use assumed to be affected by multilevel factors thus needs statistical modeling that account the effect of these factors. Understanding multilevel factors affecting contraceptive use among adolescent women is important for improving the access to and quality of health services. OBJECTIVE: The aim of this study was to assess the contraceptive use and its multilevel determinants among adolescent women in Tigray region. METHODS: A community based cross-sectional study was conducted. Women who were 15-19 years of age residing in the selected households at the time of data collection were included in the survey. Multi-stage cluster sampling was used to select study units. A multivariable two-level mixed effect binary logistic regression model was fitted to assess the effect of the explanatory variables on contraceptive use. RESULTS: A total of 1,755 adolescent women were participated. Of these 12.3% were contraceptive users. Pills (40%) and intrauterine device (30%) were commonly used contraceptive methods. Educational level, schooling, marital status, age, being informed about contraceptive, health facility visit, duration of stay at their residence, having partner and hearing of contraceptive use message through media were the most important determinants for use of contraceptive among adolescent women. Study participants who were not at school currently had more likely to use contraceptive methods compared to those who were at school (Adjusted odds ratio [AOR]=2.05; 95% confidence interval [CI]: 1.502, 4.183). Similarly, adolescent women who had no history of health facility visit had less likely to use contraceptive methods than those have history of health facility visit (AOR=0.057; 95% CI: 0.034, 0.096). Adolescent women who heard of contraceptive through median had two times (AOR=2.103; 95% CI: 1.207, 3.664) more likely to use contraceptive methods than those not heard contraceptive through media. CONCLUSION AND RECOMMENDATION: The factors affecting use of contraceptive method among adolescent women were educational level, schooling, marital status, age, being informed about contraceptive, health facility visit, duration of stay at their residence, having partner and hearing of contraceptive use message through media. This study recommends that in order to increase use of contraceptive method among adolescent women, interventions should continue like the promotion of contraceptive methods through media.

Magnitude, trends and determinants of skilled delivery from Kilite-Awlaelo Health Demographic Surveillance System, Northern Ethiopia, 2009- 2017.

BACKGROUND: The fundamental approach to improve maternal and neonatal health is increasing skilled delivery rate. Women giving birth at health institutions can prevent maternal and neonatal deaths by getting skilled birth attendance. In Ethiopia, despite a significant decrease in maternal mortality over the past decade, still a significant number of women give birth at home. Moreover, evidence from population-based longitudinal studies on skilled delivery is limited. Therefore, this study aims to investigate the magnitude, trend, and determinants of skilled delivery in Kilite-Awlaelo Health Demographic Surveillance System (KA-HDSS), Northern Ethiopia. METHOD: Population-based longitudinal study design was conducted by extracting data for nine consecutive years (2009-2017) from KA-HDSS database. In order to measure the trends of skilled delivery, KA-HDSS data sets were analyzed (2009-2017). Bivariate and multivariate analyses were performed using STATA version 16. A multivariable binary logistic regression model was fitted to assess determinants of skilled delivery and odds ratio with 95% CI was used to assess presence of associations at a 0.05 level of significance. RESULTS: The skilled delivery rate have continuously increased among reproductive age women from 15.12% (95% CI: 13.30% - 17.09%) in 2010 to 95.85% (95% CI: 94.58% - 96.895%) in 2017. The skilled delivery rate becomes high (> = 82) in the period of 2014-2017. Education, residence, marital status, occupation and antenatal care (ANC) visits were the most important determinants for skilled delivery among reproductive age women during the period of high skilled delivery rate (2014-2017). Women urban dwellers had about 28 times (AOR = 27.66; 95% CI: 3.86-196.97) higher odds to deliver by skilled birth attendants than rural dwellers. Unmarried women who gave birth were 2.18 (AOR: 2.18; 95% CI: 1.30-3.64) times more likely to have skilled delivery service compared to those married. Likewise, women with four or more ANC visits were 3.2 times more likely to undergo skilled delivery service than those having no ANC visits (AOR: 3.16; 95% CI: 2.33-4.28). Moreover, women having at least a secondary education were 2 times more likely to have skilled delivery service compared to those women with no formal education (AOR = 2.10, 95% CI: 1.18-3.74). CONCLUSION: Regardless of the importance of health facility delivery, a significant number of women still deliver at home attended by unskilled birth attendants. There has been a substantial increase in use of health facilities for delivery among women in the reproductive age. The factors affecting skilled delivery among reproductive age women were educational level, residence, marital status, occupation and use of ANC service. Maternal health related interventions are needed to change women's attitudes towards skilled delivery. Moreover, ANC coverage should be increased to improve skilled delivery service.

Prevalence and Associated Factors of Perinatal Asphyxia in Neonates Admitted to Ayder Comprehensive Specialized Hospital, Northern Ethiopia: A Cross-Sectional Study.

BACKGROUND: Perinatal asphyxia is defined as the inability of the newborn to initiate and sustain enough respiration after delivery and is characterized by a marked impairment of gas exchange. It is one of the most common causes of neonatal mortality and morbidity. There are very few studies on perinatal asphyxia in Tigray, and so this study is aimed at assessing the prevalence and associated factors of perinatal asphyxia in Ayder Comprehensive Specialized Hospital NICU, Tigray, Ethiopia. METHODS: An institution-based cross-sectional study design was conducted among neonates admitted to Ayder Comprehensive Specialized Hospital from January 1, 2016, to December 30, 2017. Medical records of 267 neonates admitted to the neonatal intensive care unit were selected by a systematic sampling method, and relevant information was collected using a checklist. The data was analyzed using SPSS version 20. Descriptive statistics were computed to determine the prevalence of birth asphyxia and sociodemographic and obstetrics data. Binary logistic regression was used to test associations between the associated factors and perinatal asphyxia. First bivariate analysis was performed to assess the association without controlling the effect of other independent variables. Variables with P value < 0.25 were fitted to the multivariable binary logistic regression model. Finally, variables with P value < 0.25 were fitted to the multivariable binary logistic regression model. Finally, variables with. RESULTS: Of the 267 neonates, 48 neonates had perinatal asphyxia, giving a prevalence of 18%. Prolonged labor (AOR = 5.19, 95% CI: 1.73-15.63, P value < 0.25 were fitted to the multivariable binary logistic regression model. Finally, variables with P value < 0.25 were fitted to the multivariable binary logistic regression model. Finally, variables with P value < 0.25 were fitted to the multivariable binary logistic regression model. Finally, variables with Conclusion and Recommendations. Prevalence and mortality of asphyxia were high. Prolonged labor, presence of meconium, and preeclampsia were determinant factors for birth asphyxia. Early detection and intervention of high-risk mothers should be carried out by health care providers, and mothers should be monitored with partograph during labor.

Reasons and multilevel factors associated with unscheduled contraceptive use discontinuation in Ethiopia: evidence from Ethiopian demographic and health survey 2016.

BACKGROUND: Contraceptive discontinuations for reasons other than the desire for pregnancy are a public health concern because of their negative effect on reproductive health outcomes. In Ethiopia, the contraceptive discontinuation rate is increasing; however the factors associated are poorly understood. So this study was aimed at assessing reasons and multilevel factors for unscheduled contraceptive use discontinuation. METHODS: This is a cross-sectional study of Ethiopian women who participated in the Ethiopian demographic health survey from January 18, 2016, to June 27, 2016. Ever using any contraceptive with in the calendar of the survey were an inclusion criteria for which 3835 women were found eligible. The data were analyzed using multilevel binary logistic regression in STATA version 14. Variables with p-value less than 0.05 were considered as statistically significant, and reported using adjusted odds ratio and 95% confidence interval. Median odds ratio and interval odds ratio, to quantify the magnitude of the general and specific contextual effect respectively, were used. Receiver operating characteristics curve and akaike's information criterion were used for model comparison. RESULT: The prevalence of unscheduled contraceptive use discontinuation was 46.18% for the principal reason of method related problems (Side effects-45.3%, needing better method-33.6%, and inconvenience-21.1%,). Women heading a household (AOR = 1.281, 95%CI 1.079-1.520), women who had no work (AOR = 0.812, 95%CI 0.673, 0.979) compared to professionals, living in poorest house hold income (AOR = 0.753, 95%CI 0.567, 0.997) compared to middle, residing in community with low contraceptive utilization rate (AOR = 1.945, 95%CI 1.618, 2.339), residing in poor community (AOR = 0.763, 95%CI 0.596-0.997), and having more children, and region were found to be significant predictors of unscheduled contraceptive use discontinuation. CONCLUSION: Method related problems were found to contribute for more than half of the contraceptive use discontinuation. Both individual and community level factors were found to significantly influence the Unscheduled contraceptive use discontinuation. The outcome was common in groups who could have more social interactions and knowledge on which myths and rumors are common. So strengthening the efforts to reduce contraceptive use discontinuation and quality of contraceptive service provision could be important.

Incidence and predictors of LTFU among adults with TB/HIV co-infection in two governmental hospitals, Mekelle, Ethiopia, 2009-2016: survival model approach.

BACKGROUND: Lost to follow-up (LTFU) negatively affects the treatment success of Anti-Retroviral Therapy (ART) and thus, increases Tuberculosis-Human Immunodeficiency Virus (TB/HIV) related morbidity, mortality and hospitalization. However, the incidence and predictors of loss to follow up (LTFU) among adults with TB/HIV co-infection have not yet well-investigated in Ethiopia. Therefore, this study was aimed at investigating the incidence and predictors of LTFU in the study setting in particular. METHODS: A facility based retrospective cohort study was employed among 305 (114 anemic and 191 normal) TB/HIV co-infected adults in two governmental hospitals (Mekelle Hospital and Ayder Comprehensive Specialized Hospital), Mekelle, Ethiopia from 2009 to 2016 and data were collected using checklist. Besides to descriptive statistics, a cox regression analysis was applied to identify statistically significant predictors of LTFU at 5% level of significance. Eventually, the Adjusted Hazard Ratio (AHR) and 95% Confidence Interval (CI) were estimated and interpreted for predictors of LTFU in the final cox model. RESULTS: Generally, 45 of 305 (14.8%) of TB/HIV co-infected adults were LTFU with an incidence rate of 4.5 new LTFUs per 100 Person Years (PYs) and a median follow up time of 3.1 years (Interquartile Range (IQR): 0.8-5.3 Years). Hemoglobin level ≤ 11.0 g/dl (AHR = 2.660; 95%CI: 1.459-4.848), and any history of OI/s (AHR = 3.795; 95%CI: 1.165-12.364) were risk factors of LTFU. While, adverse drug events (AHR = 0.451; 95%CI: 0.216-0.941), TB treatment completion (AHR = 0.121; 95% CI: 0.057-0.254), and being on Isoniazid Preventive Therapy (IPT) (AHR = 0.085; 95%CI: 0.012-0.628) had protective effect against LTFU. CONCLUSIONS: One in approximately seven TB/HIV co-infected adults had experienced of LTFU with an incidence rate 4.5 LTFUs per 100 PYs. The LTFU rate was higher among adults with low baseline hemoglobin level, no adverse drug events, presence of OI/s, failure to complete TB treatment, and being not on IPT. Therefore, it is advisable to treat anemia and active TB, and preventing the occurrence of OIs including TB using IPT to reduce the incidence of LTFU among TB/HIV co-infected adults.