Tuberculosis (TB) is a deadly infectious disease caused by various species of Mycobacteria, mainly Mycobacterium tuberculosis (Mtb). In 2010, there were 8.8 million (range, 8.5-9.2 million) incident cases of TB, 1.1 million (range, 0.9-1.2 million) deaths from TB among Human Immunodeficiency Virus (HIV) negative people and an additional 0.35 million (range, 0.32-0.39 million) deaths from HIV-associated TB globally
. However, the proportion (82%) of TB cases co-infected with HIV is highest in countries in the African Region
. Moreover, it is estimated that 50 to 60% of HIV infected people will develop TB disease in their lifetime in contrast with HIV negative persons, whose lifetime risk is only 10%
Ethiopia is among the 22 TB-high burden countries (HBCs) in the world that account for over 80% of the world’s new TB cases each year. During the year 2011, a total of 159,017 TB cases were notified in Ethiopia. Among these, 154396 (97.1%) were new cases of all forms of TB. The proportion of new smear-positive, smear negative and extra pulmonary TB (EPTB) among all new TB cases were 32%, 34%, and 32% respectively
. Ethiopia is also among the 41 high TB/HIV burden countries. In the year 2011, there were about 38000 HIV-positive new TB cases in the country. Among 65140 TB patients who were screened for HIV infection, 5,442 were found to be positive for HIV infection
. The problem of TB is attributed to a number of factors like a large number of undetected and untreated infectious TB cases, poverty, high prevalence of HIV and low health facilities in rural areas
The WHO recommends HIV testing among all TB patients, provision of co-trimoxazole preventive therapy and antiretroviral therapy for HIV-positive TB patients, intensified case-finding for TB among people receiving HIV care and isoniazid preventive therapy for HIV-positive people without active TB
. This would be practical only if all TB patients volunteer to be tested for HIV.
The rate of TB HIV co-infection is high in Ethiopia ranging from 25% to 57% in different regions of the country
[8, 9]. Thus, the national TB and HIV control guideline in Ethiopia recommends provider initiated HIV testing and counselling (PITC) as a routine care for all TB patients
. However, there is little information on the effect of this approach on the treatment seeking of TB patients
. A better understanding about the barriers to the treatment seeking of TB patients is important to identify effective strategies to improve treatment seeking among TB suspects. Therefore, the aim of this study was to assess the knowledge of TB and HIV as well as perception about PITC among TB patients attending health facilities in Harar town, Eastern Ethiopia.