Sileshi, Balewgizie (2012) Predictors of Mortality among TB-HIV Co-Infected Patients during TB Treatment in Bahirdar Town Governmental Health Institution, Ethiopia: A Retrospective Cohort Study. Masters thesis, Addis Ababa University.
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Abstract
Background: The synergy between tuberculosis and human immunodeficiency virus is strong in high human immunodeficiency virus prevalence population, in which tuberculosis is a leading cause of mortality and human immunodeficiency virus is driving the tuberculosis epidemic in many countries especially in sub-Saharan Africa. Objective: To assess predictors of mortality among TB-HIV co-infected patients during tuberculosis treatment in Bahirdar town governmental health institutions. Methods and Materials: Institution based retrospective cohort study was conducted between April, 2009 and January, 2012. Based on TB, Pre-ART and ART registration log book records of TB-HIV co-infected patients were categorized into On ART and Non-ART cohorts. Chi-square test and T- test were used to compare categorical and continuous variables between the two groups, respectively. Kaplan-Meier test was used to estimate the probability of death after tuberculosis diagnosis. The log-rank test was used to compare overall mortality between the two groups. The Cox proportional hazard model was used to determine factors associated with death after tuberculosis diagnosis. Results: A total of 422 TB-HIV co-infected patients (272 On ART and 150 Non-ART cohorts) were followed retrospectively for a median of 197 days (IQR: 140-221) in On ART and 191 days (IQR: 65.5-209.5) in Non-ART cohort. In Non-ART cohort more TB-HIV co-infected patients died during TB treatment; 44(29.3%) than On ART cohort 49(18.0%) with incidence rate of 6.03Per 100PMO (95%CI: 4.5, 8.1) and 3.20 per 100PMO (95% CI: 2.40, 4.20). Receiving ART (AHR=0.35 (0.19-0.64)), not initiation of CPT (AHR=3.03 (1.58-5.79)), being ambulatory (AHR=2.10 (1.22-3.62)), CD4 count category 0-75cells/μl, 75-150cells/μl and 150-250cells/μl (AHR=4.83 (1.98-11.77), 3.57 (1.48-8.61) and 3.07 (1.33-7.07) respectively) and treatment in hospital (AHR=2.64 (1.51-4.62)) were independent predictors of mortality during TB treatment. Conclusions: Despite the availability of free ART from health institutions, mortality was high and was strongly associated with the absence of ART during TB treatment. In line with other studies risk of death was over 65% lower in TB-HIV co-infected patients treated with ART compared with those not treated with ART.
| Item Type: | Thesis (Masters) |
|---|---|
| Subjects: | R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine R Medicine > RA Public aspects of medicine > RA1001 Forensic Medicine. Medical jurisprudence. Legal medicine |
| Divisions: | Africana |
| Depositing User: | Vincent Mpoza |
| Date Deposited: | 03 Jul 2018 11:38 |
| Last Modified: | 03 Jul 2018 11:38 |
| URI: | http://thesisbank.jhia.ac.ke/id/eprint/6522 |
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