Survival and Predictors of Mortality Among Adult HIV/AIDS Patients Initiating Highly Active Antiretroviral Therapy in Debre-Berhan Referral Hospital, Amhara, Ethiopia: A Retrospective Study

Fetene Nigussie,1 Abayneh Alamer,2 Zuriyash Mengistu,3 Erdaw Tachbele3 1Department of Nursing, College of Health Science, Institute of Medicine and Health Sciences, Debre Berhan University, Debre Berhan, Ethiopia; 2Department of Physiotherapy, College of Health Sciences, Ayder Comprehensive Speciali...

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Autores principales:	Nigussie F, Alamer A, Mengistu Z, Tachbele E
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2020
Materias:	amhara haart hiv/aids predictors survival debre berhan referral hospital Immunologic diseases. Allergy RC581-607
Acceso en línea:	https://doaj.org/article/59b0c279cb4942278cde2a1a9bf93b43
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spelling	oai:doaj.org-article:59b0c279cb4942278cde2a1a9bf93b432021-12-02T12:20:56ZSurvival and Predictors of Mortality Among Adult HIV/AIDS Patients Initiating Highly Active Antiretroviral Therapy in Debre-Berhan Referral Hospital, Amhara, Ethiopia: A Retrospective Study1179-1373https://doaj.org/article/59b0c279cb4942278cde2a1a9bf93b432020-11-01T00:00:00Zhttps://www.dovepress.com/survival-and-predictors-of-mortality-among-adult-hivaids-patients-init-peer-reviewed-article-HIVhttps://doaj.org/toc/1179-1373Fetene Nigussie,1 Abayneh Alamer,2 Zuriyash Mengistu,3 Erdaw Tachbele3 1Department of Nursing, College of Health Science, Institute of Medicine and Health Sciences, Debre Berhan University, Debre Berhan, Ethiopia; 2Department of Physiotherapy, College of Health Sciences, Ayder Comprehensive Specialized Hospital, Mekelle University, Mekelle, Ethiopia; 3Department of Nursing, College of Health Sciences, Addis Ababa University, Addis Ababa, EthiopiaCorrespondence: Fetene NigussieDepartment of Nursing, College of Health Science, Institute of Medicine and Health Sciences, Debre Berhan University, PO Box 445, Debre Berhan, EthiopiaTel +251 932274797Email fetenenigussie27@gmail.comBackground: Acquired immune deficiency syndrome is one of the most destructive epidemics the world has ever witnessed. An estimated 36.9 million people were living with HIV in 2017. HIV/AIDS is the major contributing factor for morbidity and mortality in low- and middle-income countries. Although different studies on survival and predictors of mortality among HIV/AIDS patients after initiation of antiretroviral therapy were conducted, there are inconsistencies in the findings of those studies. Furthermore, to the authors’ knowledge, there was a dearth of studies conducted in this study area.Purpose: The purpose of this study was to assess the survival and predictors of mortality among adult patients starting highly active antiretroviral therapy at Debre Berhan Referral Hospital, North Showa, Amhara, Ethiopia.Patients and Methods: An institution-based retrospective study was conducted among the medical records of 447 study subjects’ selected using simple random sampling from January 1t, 2013 to December 30, 2018. The data was collected using a structured data abstraction checklist and analyzed using Kaplan–Meier statistics and Cox regression models.Results: Among 447 adult patients, 54 patients (12.1%) had died, giving a crude death rate of 4.18 per 100 person years (95% CI=3.20– 5.45). The overall estimated survival rate after initiation of antiretroviral therapy was 81.7% (95% CI=75.36– 86.54%) at 72 months of follow-up. The independent predictors of mortality were clinical stage IV (HR=15.6, 95% CI=6.609– 36.948), baseline opportunistic infections (HR=1.86, 95% CI=1.048– 3.330), baseline Hgb< 10 mg/dL (HR=4.655, 95% CI=2.253– 9.619), baseline CD4< 200 cells/μL (HR=4.71, 95% CI=2.275– 9.751), the presence of comorbidity (HR=2.56 95% CI=1.391– 4.740), being widowed (HR=3.475, 95% CI=1.412– 8.550), and bedridden functional status (HR=3.069, 95% CI=1.111– 8.480).Conclusion: Patients with opportunistic infections, advanced clinical stage disease, bedridden functional status, baseline Hgb< 10 mg/dL, baseline CD4< 200 cells/μL, and comorbidity should be given special care.Keywords: Amhara, HAART, HIV/AIDS, predictors, survival, Debre Berhan Referral HospitalNigussie FAlamer AMengistu ZTachbele EDove Medical Pressarticleamharahaarthiv/aidspredictorssurvivaldebre berhan referral hospitalImmunologic diseases. AllergyRC581-607ENHIV/AIDS: Research and Palliative Care, Vol Volume 12, Pp 757-768 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	amhara haart hiv/aids predictors survival debre berhan referral hospital Immunologic diseases. Allergy RC581-607
spellingShingle	amhara haart hiv/aids predictors survival debre berhan referral hospital Immunologic diseases. Allergy RC581-607 Nigussie F Alamer A Mengistu Z Tachbele E Survival and Predictors of Mortality Among Adult HIV/AIDS Patients Initiating Highly Active Antiretroviral Therapy in Debre-Berhan Referral Hospital, Amhara, Ethiopia: A Retrospective Study
description	Fetene Nigussie,1 Abayneh Alamer,2 Zuriyash Mengistu,3 Erdaw Tachbele3 1Department of Nursing, College of Health Science, Institute of Medicine and Health Sciences, Debre Berhan University, Debre Berhan, Ethiopia; 2Department of Physiotherapy, College of Health Sciences, Ayder Comprehensive Specialized Hospital, Mekelle University, Mekelle, Ethiopia; 3Department of Nursing, College of Health Sciences, Addis Ababa University, Addis Ababa, EthiopiaCorrespondence: Fetene NigussieDepartment of Nursing, College of Health Science, Institute of Medicine and Health Sciences, Debre Berhan University, PO Box 445, Debre Berhan, EthiopiaTel +251 932274797Email fetenenigussie27@gmail.comBackground: Acquired immune deficiency syndrome is one of the most destructive epidemics the world has ever witnessed. An estimated 36.9 million people were living with HIV in 2017. HIV/AIDS is the major contributing factor for morbidity and mortality in low- and middle-income countries. Although different studies on survival and predictors of mortality among HIV/AIDS patients after initiation of antiretroviral therapy were conducted, there are inconsistencies in the findings of those studies. Furthermore, to the authors’ knowledge, there was a dearth of studies conducted in this study area.Purpose: The purpose of this study was to assess the survival and predictors of mortality among adult patients starting highly active antiretroviral therapy at Debre Berhan Referral Hospital, North Showa, Amhara, Ethiopia.Patients and Methods: An institution-based retrospective study was conducted among the medical records of 447 study subjects’ selected using simple random sampling from January 1t, 2013 to December 30, 2018. The data was collected using a structured data abstraction checklist and analyzed using Kaplan–Meier statistics and Cox regression models.Results: Among 447 adult patients, 54 patients (12.1%) had died, giving a crude death rate of 4.18 per 100 person years (95% CI=3.20– 5.45). The overall estimated survival rate after initiation of antiretroviral therapy was 81.7% (95% CI=75.36– 86.54%) at 72 months of follow-up. The independent predictors of mortality were clinical stage IV (HR=15.6, 95% CI=6.609– 36.948), baseline opportunistic infections (HR=1.86, 95% CI=1.048– 3.330), baseline Hgb< 10 mg/dL (HR=4.655, 95% CI=2.253– 9.619), baseline CD4< 200 cells/μL (HR=4.71, 95% CI=2.275– 9.751), the presence of comorbidity (HR=2.56 95% CI=1.391– 4.740), being widowed (HR=3.475, 95% CI=1.412– 8.550), and bedridden functional status (HR=3.069, 95% CI=1.111– 8.480).Conclusion: Patients with opportunistic infections, advanced clinical stage disease, bedridden functional status, baseline Hgb< 10 mg/dL, baseline CD4< 200 cells/μL, and comorbidity should be given special care.Keywords: Amhara, HAART, HIV/AIDS, predictors, survival, Debre Berhan Referral Hospital
format	article
author	Nigussie F Alamer A Mengistu Z Tachbele E
author_facet	Nigussie F Alamer A Mengistu Z Tachbele E
author_sort	Nigussie F
title	Survival and Predictors of Mortality Among Adult HIV/AIDS Patients Initiating Highly Active Antiretroviral Therapy in Debre-Berhan Referral Hospital, Amhara, Ethiopia: A Retrospective Study
title_short	Survival and Predictors of Mortality Among Adult HIV/AIDS Patients Initiating Highly Active Antiretroviral Therapy in Debre-Berhan Referral Hospital, Amhara, Ethiopia: A Retrospective Study
title_full	Survival and Predictors of Mortality Among Adult HIV/AIDS Patients Initiating Highly Active Antiretroviral Therapy in Debre-Berhan Referral Hospital, Amhara, Ethiopia: A Retrospective Study
title_fullStr	Survival and Predictors of Mortality Among Adult HIV/AIDS Patients Initiating Highly Active Antiretroviral Therapy in Debre-Berhan Referral Hospital, Amhara, Ethiopia: A Retrospective Study
title_full_unstemmed	Survival and Predictors of Mortality Among Adult HIV/AIDS Patients Initiating Highly Active Antiretroviral Therapy in Debre-Berhan Referral Hospital, Amhara, Ethiopia: A Retrospective Study
title_sort	survival and predictors of mortality among adult hiv/aids patients initiating highly active antiretroviral therapy in debre-berhan referral hospital, amhara, ethiopia: a retrospective study
publisher	Dove Medical Press
publishDate	2020
url	https://doaj.org/article/59b0c279cb4942278cde2a1a9bf93b43
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Survival and Predictors of Mortality Among Adult HIV/AIDS Patients Initiating Highly Active Antiretroviral Therapy in Debre-Berhan Referral Hospital, Amhara, Ethiopia: A Retrospective Study

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