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

Wondimu Abuto,1 Admas Abera,2 Tesfaye Gobena,2 Tariku Dingeta,2 Melese Markos3 1Public Health Emergency Management, Kembata Tembaro Zonal Health Department, Durame, Southern Nations Nationalities Peoples’ Region, Ethiopia; 2School of Public Health, Haramaya University, Harar, Ethiopia; 3De...

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Autores principales:	Abuto W, Abera A, Gobena T, Dingeta T, Markos M
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2021
Materias:	survival mortality predictors hiv/aids haart low-resource setting Immunologic diseases. Allergy RC581-607
Acceso en línea:	https://doaj.org/article/11ed042f776b4211a9bc027b26cef5c1
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spelling	oai:doaj.org-article:11ed042f776b4211a9bc027b26cef5c12021-12-02T11:36:26ZSurvival 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 Study1179-1373https://doaj.org/article/11ed042f776b4211a9bc027b26cef5c12021-03-01T00:00:00Zhttps://www.dovepress.com/survival-and-predictors-of-mortality-among-hiv-positive-adult-patients-peer-reviewed-article-HIVhttps://doaj.org/toc/1179-1373Wondimu Abuto,1 Admas Abera,2 Tesfaye Gobena,2 Tariku Dingeta,2 Melese Markos3 1Public Health Emergency Management, Kembata Tembaro Zonal Health Department, Durame, Southern Nations Nationalities Peoples’ Region, Ethiopia; 2School of Public Health, Haramaya University, Harar, Ethiopia; 3Department of Public Health, Dire Dawa University, Dire Dawa, EthiopiaCorrespondence: Admas AberaHaramaya University, P.O. Box 235, Harar, EthiopiaEmail admasabera10@gmail.comBackground: 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), Fair-adherence 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.Keywords: survival, mortality, predictors, HIV/AIDS, HAART, low-resource settingAbuto WAbera AGobena TDingeta TMarkos MDove Medical Pressarticlesurvivalmortalitypredictorshiv/aidshaartlow-resource settingImmunologic diseases. AllergyRC581-607ENHIV/AIDS: Research and Palliative Care, Vol Volume 13, Pp 271-281 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	survival mortality predictors hiv/aids haart low-resource setting Immunologic diseases. Allergy RC581-607
spellingShingle	survival mortality predictors hiv/aids haart low-resource setting Immunologic diseases. Allergy RC581-607 Abuto W Abera A Gobena T Dingeta T Markos M 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
description	Wondimu Abuto,1 Admas Abera,2 Tesfaye Gobena,2 Tariku Dingeta,2 Melese Markos3 1Public Health Emergency Management, Kembata Tembaro Zonal Health Department, Durame, Southern Nations Nationalities Peoples’ Region, Ethiopia; 2School of Public Health, Haramaya University, Harar, Ethiopia; 3Department of Public Health, Dire Dawa University, Dire Dawa, EthiopiaCorrespondence: Admas AberaHaramaya University, P.O. Box 235, Harar, EthiopiaEmail admasabera10@gmail.comBackground: 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), Fair-adherence 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.Keywords: survival, mortality, predictors, HIV/AIDS, HAART, low-resource setting
format	article
author	Abuto W Abera A Gobena T Dingeta T Markos M
author_facet	Abuto W Abera A Gobena T Dingeta T Markos M
author_sort	Abuto W
title	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
title_short	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
title_full	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
title_fullStr	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
title_full_unstemmed	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
title_sort	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
publisher	Dove Medical Press
publishDate	2021
url	https://doaj.org/article/11ed042f776b4211a9bc027b26cef5c1
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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

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