Incidence and Determinants of Mortality among Adult Patients Taking Antiretroviral Therapy in Ethiopia: Systematic Review and Meta-Analysis

Abstract

Reduced AIDS mortality has been linked to the advent of highly active antiretroviral medication. The previous reviews conducted in Ethiopia lack the overall rigor and clarity in the study methodology, reported results and statistical inference. The goal was to create a data summary from studies accomplished previously throughout the nation so that programmers and implementers could use to harmonize the current advanced intervention and direct health service providers to improve ART service provision packages. This data would provide a thorough update on the magnitude of mortality among HIV-infected patients taking HAART by combining 21 eligible articles. The study's heterogeneity, publication bias, and quality were examined. The statistical analysis used random-effects model in STATA version 14. The protocol was registered(CRD42019123380). As a result, the pooled mortality incidence was 5 per 100 person-years of observation (95% CI: 4–5 per 100 pyo). Two-thirds of deaths occurred within the first year of starting HAART. Clinical stage (Pooled HR = 3.15; 95% CI: 2.36–4.21), CD4 count (Pooled HR = 2.31; 95% CI: 1.83–2.93), hemoglobin level (Pooled HR = 3.05; 95% CI: 2.19–4.27), TB co-infection (Pooled HR = 3.08; 95% CI: 2.21–4.29), and functional status (Pooled HR = 4.86; 95% CI: 3.59–6.97) were factors in this study that were substantially linked to higher mortality. Mortality rates were high, especially early in the therapeutic process. Significant mortality risk factors were WHO clinical stage, CD4 count, poor hemoglobin, TB co-infection, and non-working functional status. This significant mortality rate could be avoided with comprehensive care and stringent monitoring.