Survival and Predictors of Mortality Among HIV Positive Adult Patients on Highly Active Antiretroviral Therapy in Public Hospitals of Kambata Tambaro Zone, Southern Ethiopia: A Retrospective Cohort Study

Abstract

Background: Human Immune Deficiency Virus (HIV) infection remains the leading cause of morbidity and mortality. In Ethiopia, despite test and treat all HIV positives are adopted, a significant number of people eligible for Anti-Retroviral Therapy (ART) show up with advanced disease and at lower CD4 count. There is currently paucity of studies conducted that investigate predictors of mortality among adults on ART in the study area. Objective: To explore Survival and predictors of mortality among adult HIV-positive patients on ART in Kambata Tambaro Zone, Ethiopia, from August 2013 to February 2019. Methods: A health facility-based retrospective cohort study was conducted among records of 467 adult HIV-positive patients on ART selected using simple random sampling. Data were collected using standardized abstraction tool. Kaplan-Meier, Log rank tests and Cox regression model was applied to estimate survival status and identify predictors of mortality, respectively. Results: Of the total 467 study subjects, 59 (12.63%) of them died in the study period. The median follow-up time of the cohort was 40.1 (IQR=13.6-59.0) months. The mortality rate of the cohort was 4.1 per 100 PYO. The overall survival probability of the cohort was 84.38% (95 CI=80.08-87.82) at 66 months. Bedridden function AHR=3.0 (95% CI, 1.44-6.64), Fairadherence AHR=3.3 (95% CI, 1.50-7.07), Poor-adherence AHR=3.8 (95% CI, 1.88-7.96), presence of OIs AHR=4.2 (95% CI, 1.98-8.50), Late diagnosis (CD4 count >/=350) AHR=3.0 (95% CI, 1.91-6.42) and Immunologic failure AHR=3.5 (95% CI, 1.41-6.29) were independent predictors of time to death in Cox-Regression. Conclusion: Late Diagnosis, poor adherence, being bedridden, having OI and Immunologic failure were independently associated with time to death. Early diagnosis to start treatment and emphasizing on close follow-up care to improve treatment adherence should be given special emphasis.

Predictors of Mortality Among Adult HIV-Infected Patients Taking Antiretroviral Therapy (ART) in Harari Hospitals, Ethiopia

“…The nonworking functional status of the study participants had higher hazards of deaths among HIV/AIDS patients taking ART than their counterparts. The finding was in line with the study conducted in South Ethiopia, 35 , 36 the Amhara region, 26 Somali region, Ethiopia, 17 Kenya, 37 and India. 38 It is a fact that patients with advanced clinical stages of HIV/AIDS due to super-infected with opportunistic infections and cancers, may be presented with deteriorated quality of life such as unable to perform daily living activities like bathing, eating, and clothing.…”

Predictors of Survival Time Among HIV-Infected Adults After Initiating Anti-Retroviral Therapy in Kombolcha Town: A 5-Year Retrospective Cohort Study

“…Likewise, the hazard of adult mortality was 9.58 times higher among adults with poor drug adherence than adults who had good adherence to ART (AHR=9.58, 95% CI: 8.72–30.97). This is consistent with other studies in Nekemet, 22 Kambata Tambaro Zone 16 (AHR = 3.8, 95% CI: 1.88, 7.96) Goffa zone, 13 Canada. 23 …”

“…This is in line with other studies in Aksum hospital (8.85%) 8 Oromia region (10.3%), 9 Eastern Ethiopia (5.9%), 10 Tigray central zone (7.5%), 11 Jinka hospital (10%), 12 Gofa zone hospital (7.5%) 13 and Latin America (7.3%). 14 However, this finding is lower than studies in Hiwot Fana teaching hospital (11.9%), 15 Kambata tambaro zone (12.63%), 16 Malawi (12.6%), 17 Durban, South Africa (16%) 18 and India (13%, 16.1%). 19 , 20 The difference might be due to differences in socioeconomic characteristics and duration of follow-up.…”

Effects of Chinese Medicine on the Survival of AIDS Patients Administered Second-Line ART in Rural Areas of China: A Retrospective Cohort Study Based on Real-World Data

“…Although we used PSM to control for selection bias, a retrospective cohort study is intrinsically biased. Furthermore, specific important variables associated with mortality, such as adherence to ART, body mass index, anemia, hyperlipemia, and liver injury [ 31 – 33 ], were not recorded when patients switched to second-line ART.…”