Assessment of Factors Associated with High Risk of Mortality of HIV Patients Treated with Highly Active Antiretroviral Therapy in Jimma Zone, South Western Ethiopia: Application of Survival Analysis Methods

Birtukan, Tsehaineh (2010) Assessment of Factors Associated with High Risk of Mortality of HIV Patients Treated with Highly Active Antiretroviral Therapy in Jimma Zone, South Western Ethiopia: Application of Survival Analysis Methods. Masters thesis, Addis Ababa University.

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Abstract

Background: The introduction of HAART has brought about a significant reduction in the morbidity and mortality of patients with HIV infection. However, the mortality rate of patients treated with HAART is still very high in resource-poor settings. Factors contributing to this high mortality rate are poorly understood. Objective: The objective of this study is to identify the determinant factors of HIV associated mortality in a cohort of HIV infected patients treated with HAART. Method: The study has reviewed patient forms and follow up cards of 832 patients treated with HAART in Jimma University Specialized Hospital from 2003-2007. The minimum follow up time was 1 month and the maximum was 78 months. Kaplan-Meier survival curves and Log-Rank test were used to compare the survival experience of different groups of patients and proportional hazards Cox model was used to explore the factors associated with increased risk of mortality. Results: Some 144 patients died during the follow up time of which 48.6% and 68.8% deaths occurred within three and six months of HAART initiation, respectively. The overall mean estimated survival time of patients was 63.7 months. Factors/covariates associated with increased risk of mortality were older age, (HR=1.03, 95% CI: 1.01-1.051), low CD4 count at baseline (HR=0.994, 95% CI: 0.992-0.996), low weight at baseline (HR for a 5kg change=0.902, 95% CI: 0.816-0.996), bedridden and ambulatory functional status (HR=6.904, 95% CI: 4.005-11.902) and (HR=2.877, 95% CI: 1.899-4.360), respectively, co-infection with TB (HR=1.906, 95% CI: 1.305-2.784) and substance use (HR=1.42, 95% CI: 1.016-1.985). Conclusion: The mortality rate of patients was high at the earlier time of treatment. Moreover, laboratory and clinical factors are associated with increased risk of mortality. Thus, those patients with poor laboratory/clinical characteristics should be identified and treated early before they progress to advanced disease stages.

Item Type:	Thesis (Masters)
Subjects:	H Social Sciences > H Social Sciences (General) H Social Sciences > HA Statistics R Medicine > RA Public aspects of medicine R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Divisions:	Africana
Depositing User:	Selom Ghislain
Date Deposited:	24 Sep 2018 13:15
Last Modified:	24 Sep 2018 13:15
URI:	http://thesisbank.jhia.ac.ke/id/eprint/5477

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