Awareness and Determinants among Health Workers of Lipoarabinomannan as a Rapid Diagnostic Test for Extra-Pulmonary Tuberculosis in HIV-Positive Patients in Selected Addis Ababa City Public Hospitals, 2025

Abstract

Tuberculosis remains a global health challenge with extra-pulmonary tuberculosis disproportionately affecting HIV-positive individuals due to compromised immunity and the diagnostic limitations of traditional tools. The Lipoarabinomannan test a rapid and affordable antigen-based assay has proven effective in detecting TB in urine samples of severely immunocompromised HIV-positive patients particularly in resource-limited settings. However, healthcare professionals' awareness is key to using the LAM test effectively in patient care. Objective: To assess the awareness and determinants among healthcare workers regarding the use of Lipoarabinomannan testing for the diagnosis of extra-pulmonary tuberculosis in HIVpositive patients Addis Ababa, 2025.

Method: An institutional-based cross-sectional study was conducted in three public hospitals in Addis Ababa, Ethiopia. The study sites included St. Peter’s Hospital, Zewditu Hospital and ALERT Center. The study was carried out from October 14, 2024, to March 18, 2025, to assess healthcare workers' awareness refers to the level of knowledge health workers have about the LAM test assessed through structured questionnaires. The data was summarized using descriptive statistics. Bivariable and multivariable logistic regression analyses examined associations and controlled confounders. SPSS version 23 software was used for analysis. Results: This study found a significant gap in LAM testing awareness among healthcare workers in Addis Ababa's public hospitals, with only 47.4% demonstrating sufficient knowledge. Awareness was influenced by factors such as work experience, department, institutional support, and test availability, with higher usage and support improving awareness. These findings highlight the need for training, support, and access to enhance tuberculosis diagnosis in HIVpositive patients.

Recommendation: To improve LAM testing awareness and use, institutions should provide educational materials and workshops for all healthcare staff, including emergency and inpatient teams. Include LAM in CPD and on-the-job training. Leadership should promote and support its use, and ensure consistent test kit availability, especially in high HIV/TB burden areas