Amsalu, Melkam (2015) Survival Status among People Living with HIV/AIDS on Highly Active Anti Retroviral Therapy at Federal Police Referral Hospital, Ethiopia, Retrospective Cohort Study. Masters thesis, Addis Ababa University.
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PDF (Survival Status among People Living with HIV/AIDS on Highly Active Anti Retroviral Therapy at Federal Police Referral Hospital, Ethiopia, Retrospective Cohort Study)
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Abstract
Background: HIV/AIDS affects many people globally and its burden was critical. According to the 2005 ANC - based HIV sentinel surveillance the prevalence of HIV at Federal police referral Hospital was 24.8%. The introduction of HAART significantly improved survival and quality of life for many individuals living with the disease. In Ethiopia studies also showed the contribution of HAART for patients. However, still there is lack of information on its outcome among the police community. Objective: The aim of this study is to assess survival of HIV/AIDS patients on HAART. Methods: Retrospective cohort study was conducted among HIV patients on HAART from Apr, 2005 to Mar, 2013 at Federal Police Referral Hospital, on a total sample size of 900, selected using systematic random sampling technique. Descriptive statistics to summarize characteristics of the study subjects, Kaplan - Meier survival function to estimate the probability of survival, log - rank test to compare survival in two or more groups and Cox proportional hazard model to determine factors associated with outcome was applied. Result: The median follow up period was 57 months (IQR, 23 - 89). The overall survival was 88% at 120 months follow up. About 8.3% of patients died and mortality was high (48%) in the first 6 month of follow up. Baseline ART regimen TDF+3TC+EFV (AHR=6.4,95%CI;1.6–25) and TDF+3TC+NVP (AHR=167.6,95% CI; 7.9 – 3525), Not working due to ill health (AHR =2.9,95% CI; 1.2 - 6.9), use of condom rarely (AHR =4.6, 95% CI; 1.6 – 12.7), Ambulatory (AHR =2.8, 95% CI; 1.2 – 6.9), Bed ridden (AHR =11.3,95% CI; 4.6 - 27), PCP (AHR = 3.6,95% CI; 1.4 – 9.2), WHO Treatment stage one (AHR=0.10,95%CI;0.03–0.4), Prophylaxis (AHR=2.6,95% CI:1.1–6.4), Current ART regimen TDF+3TC+EFV (AHR=0.2,95% CI; 0.05–0.76) and TDF+3TC+NVP (AHR =0.09,95% CI; 0.01–0.83), Fair drug adherence (AHR= 3.1,95% CI;1.6 – 6.2) and Recent CD4 cell count (AHR =0.99,95% CI; 0.994– 0.999) were the significant predictors for mortality after initiation of HAART among HIV patients in the adjusted Cox proportional hazard model. Conclusion: HAART improved survival. However, high mortality was observed in the first six month of follow up. It was associated with Baseline ART regiment, not working due to ill health , use of condom rarely, Ambulatory and bed ridden functional status, PCP after starting ART, current prophylaxis and fair adherence. Highlighting, the need for early and strong HIV testing and counseling to initiate treatment early before they progress to advanced stage.
| Item Type: | Thesis (Masters) |
|---|---|
| Subjects: | R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine |
| Divisions: | Africana |
| Depositing User: | Emmanuel Ndorimana |
| Date Deposited: | 29 Oct 2018 13:34 |
| Last Modified: | 29 Oct 2018 13:34 |
| URI: | http://thesisbank.jhia.ac.ke/id/eprint/7113 |
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