Effect of late HIV diagnosis on HIV-related mortality among adults in general hospitals of Central Zone Tigray, northern Ethiopia: a retrospective cohort study

Hadera Belay,1 Fessahaye Alemseged,2 Teklit Angesom,1 Solomon Hintsa,1 Mebrahtu Abay1 1Department of Public Health, College of Health Sciences, Aksum University, Aksum, Ethiopia; 2Department of Epidemiology, College of Medicine and Health Sciences, Jimma University, Jimma, Ethiopia Background: The g...

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Autores principales:	Belay H, Alemseged F, Angesom T, Hintsa S, Abay M
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2017
Materias:	HIV early/late diagnosis CD4 cell count HIV related mortality Tigray Ethiopia Immunologic diseases. Allergy RC581-607
Acceso en línea:	https://doaj.org/article/dbbe608b290048da9678dd031d0238ce
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spelling	oai:doaj.org-article:dbbe608b290048da9678dd031d0238ce2021-12-02T01:36:30ZEffect of late HIV diagnosis on HIV-related mortality among adults in general hospitals of Central Zone Tigray, northern Ethiopia: a retrospective cohort study1179-1373https://doaj.org/article/dbbe608b290048da9678dd031d0238ce2017-09-01T00:00:00Zhttps://www.dovepress.com/effect-of-late-hiv-diagnosis-on-hiv-related-mortality-among-adults-in--peer-reviewed-article-HIVhttps://doaj.org/toc/1179-1373Hadera Belay,1 Fessahaye Alemseged,2 Teklit Angesom,1 Solomon Hintsa,1 Mebrahtu Abay1 1Department of Public Health, College of Health Sciences, Aksum University, Aksum, Ethiopia; 2Department of Epidemiology, College of Medicine and Health Sciences, Jimma University, Jimma, Ethiopia Background: The global incidence of HIV infection is not significantly decreasing, especially in sub-Saharan African countries, including Ethiopia. Though there is availability and accessibility of free HIV services, people are not being diagnosed early for HIV, and hence patients are still dying of HIV-related causes. This research is aimed at verifying the effect of late diagnosis of HIV on HIV-related mortality in Central Zone Tigray, Ethiopia. Methods: A retrospective cohort study among adult (≥15 years old) HIV patients in three general hospitals of Tigray was conducted. Record reviews were carried out retrospectively from 2010 to 2015. Sample size was determined using stpower Cox in Stata software. Data were entered into EpiData version 3.1 software and transferred to Stata version 12 for analysis. Both bivariable and multivariable analyses were performed using Cox regression model to compare the HIV-related mortality of exposed (cluster of differentiation 4 cells count <350 cells/mm3) and nonexposed (≥350 cells/mm3) patients using adjusted hazard ratio (AHR) at 95% confidence interval (CI). Result: In all, 638 HIV patients were analyzed, contributing 2,105.6 person-years. Forty-eight (7.5%) patients died of HIV-related causes with a mortality rate of 2.28 per 100 person-years. In the multivariable Cox regression model, patients with late diagnosis of HIV had a higher risk of mortality (AHR =3.22, 95% CI: 1.17–8.82) than patients with early diagnosis of HIV. Rural residence (AHR =1.96, 95% CI: 1.05–3.68), unemployment (AHR =2.70, 95% CI: 1.03–7.08), bedridden patients (AHR =2.98, 95% CI: 1.45–6.13), ambulatory patients (AHR =2.54, 95% CI: 1.05–6.15), and baseline hemoglobin level of <11 mg/dL (AHR =3.06, 95% CI: 1.51–6.23) were other independent predictors of mortality. Conclusion and recommendations: Late diagnosis of HIV increased HIV-related mortality. Rural residence, unemployment, bedridden and ambulatory patients, and baseline hemoglobin level <11 mg/dL were also independent predictors of HIV-related mortality. Keywords: HIV, early/late diagnosis, CD4 cell count, HIV-related mortality, Tigray, EthiopiaBelay HAlemseged FAngesom THintsa SAbay MDove Medical PressarticleHIVearly/late diagnosisCD4 cell countHIV related mortalityTigrayEthiopiaImmunologic diseases. AllergyRC581-607ENHIV/AIDS: Research and Palliative Care, Vol Volume 9, Pp 187-192 (2017)
institution	DOAJ
collection	DOAJ
language	EN
topic	HIV early/late diagnosis CD4 cell count HIV related mortality Tigray Ethiopia Immunologic diseases. Allergy RC581-607
spellingShingle	HIV early/late diagnosis CD4 cell count HIV related mortality Tigray Ethiopia Immunologic diseases. Allergy RC581-607 Belay H Alemseged F Angesom T Hintsa S Abay M Effect of late HIV diagnosis on HIV-related mortality among adults in general hospitals of Central Zone Tigray, northern Ethiopia: a retrospective cohort study
description	Hadera Belay,1 Fessahaye Alemseged,2 Teklit Angesom,1 Solomon Hintsa,1 Mebrahtu Abay1 1Department of Public Health, College of Health Sciences, Aksum University, Aksum, Ethiopia; 2Department of Epidemiology, College of Medicine and Health Sciences, Jimma University, Jimma, Ethiopia Background: The global incidence of HIV infection is not significantly decreasing, especially in sub-Saharan African countries, including Ethiopia. Though there is availability and accessibility of free HIV services, people are not being diagnosed early for HIV, and hence patients are still dying of HIV-related causes. This research is aimed at verifying the effect of late diagnosis of HIV on HIV-related mortality in Central Zone Tigray, Ethiopia. Methods: A retrospective cohort study among adult (≥15 years old) HIV patients in three general hospitals of Tigray was conducted. Record reviews were carried out retrospectively from 2010 to 2015. Sample size was determined using stpower Cox in Stata software. Data were entered into EpiData version 3.1 software and transferred to Stata version 12 for analysis. Both bivariable and multivariable analyses were performed using Cox regression model to compare the HIV-related mortality of exposed (cluster of differentiation 4 cells count <350 cells/mm3) and nonexposed (≥350 cells/mm3) patients using adjusted hazard ratio (AHR) at 95% confidence interval (CI). Result: In all, 638 HIV patients were analyzed, contributing 2,105.6 person-years. Forty-eight (7.5%) patients died of HIV-related causes with a mortality rate of 2.28 per 100 person-years. In the multivariable Cox regression model, patients with late diagnosis of HIV had a higher risk of mortality (AHR =3.22, 95% CI: 1.17–8.82) than patients with early diagnosis of HIV. Rural residence (AHR =1.96, 95% CI: 1.05–3.68), unemployment (AHR =2.70, 95% CI: 1.03–7.08), bedridden patients (AHR =2.98, 95% CI: 1.45–6.13), ambulatory patients (AHR =2.54, 95% CI: 1.05–6.15), and baseline hemoglobin level of <11 mg/dL (AHR =3.06, 95% CI: 1.51–6.23) were other independent predictors of mortality. Conclusion and recommendations: Late diagnosis of HIV increased HIV-related mortality. Rural residence, unemployment, bedridden and ambulatory patients, and baseline hemoglobin level <11 mg/dL were also independent predictors of HIV-related mortality. Keywords: HIV, early/late diagnosis, CD4 cell count, HIV-related mortality, Tigray, Ethiopia
format	article
author	Belay H Alemseged F Angesom T Hintsa S Abay M
author_facet	Belay H Alemseged F Angesom T Hintsa S Abay M
author_sort	Belay H
title	Effect of late HIV diagnosis on HIV-related mortality among adults in general hospitals of Central Zone Tigray, northern Ethiopia: a retrospective cohort study
title_short	Effect of late HIV diagnosis on HIV-related mortality among adults in general hospitals of Central Zone Tigray, northern Ethiopia: a retrospective cohort study
title_full	Effect of late HIV diagnosis on HIV-related mortality among adults in general hospitals of Central Zone Tigray, northern Ethiopia: a retrospective cohort study
title_fullStr	Effect of late HIV diagnosis on HIV-related mortality among adults in general hospitals of Central Zone Tigray, northern Ethiopia: a retrospective cohort study
title_full_unstemmed	Effect of late HIV diagnosis on HIV-related mortality among adults in general hospitals of Central Zone Tigray, northern Ethiopia: a retrospective cohort study
title_sort	effect of late hiv diagnosis on hiv-related mortality among adults in general hospitals of central zone tigray, northern ethiopia: a retrospective cohort study
publisher	Dove Medical Press
publishDate	2017
url	https://doaj.org/article/dbbe608b290048da9678dd031d0238ce
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Effect of late HIV diagnosis on HIV-related mortality among adults in general hospitals of Central Zone Tigray, northern Ethiopia: a retrospective cohort study

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