Ashagre, Solomon (2012) Survival and Its Predictors among Children on ART in Hawassa Referral Hospital, Adare Hospital and Bushulo Health Centre, South Ethiopia: Retrospective Cohort Study. Masters thesis, Addis Ababa University.
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Abstract
Introduction: HIV develops very rapidly among infants and children, and, without treatment, a third of children with HIV will die of AIDS before their first birthday, with half dying before they are two. In 2009, there were 260,000 deaths attributed to HIV in under-15, most of which could have been prevented through early diagnosis and effective treatment. Highly Active Antiretroviral Therapy has improved the survival of HIV infected patients. Low baseline CD4, low weight for age, and high viral load levels were identified by studies as strong predictors of mortality. Objective: To assess survival rate and predictors of survival among children on ART in Hawassa Referral Hospital , Adare Hospital and Bushulo Health Center, Hawassa . Methodology: A retrospective cohort study was conducted among children on ART. A total of 222 patient’s records enrolled between July 28, 2006 to September10, 2011 was reviewed. Kalpan Meir survival analysis was used to estimate mean survival time and Life table was used to estimate survival probability after introduction of ART and log rank test was be used to compare Hazard curves. Cox proportional-hazard regression was used to calculate the bivariate and adjusted hazard rate and then determine independent predictors of mortality. Results: A total of 222 children started on ART were followed for a median of 20 months (IQR=9-35.25). Among the cohort 119 (53.6%) were male the median age was 7(IQR=4-10). The mean hemoglobin was 9.9 (SD, 4.22) and median CD4 count was 272.5 cells/µl (IQR=164.75-446.25). The mean survival time of the entire cohort was 53.2 months (95% CI 50.35-56.0). The independent determinants of mortality were WHO clinical sage IV AHR =9.64 (95%CI 1.92-48.41) and low haemoglobin value(Hgb<7.00gm/dl) AHR=4.28(95% CI 1.53- 11.93), stunting AHR=3.992(95%CI1.24-12.77), wasting AHR=3.770 (95%CI1.28-11.12 ). Conclusion: Despite apparent benefit of ART there is high early mortality. A careful monitoring of patients with low hemoglobin, advanced WHO staging, Stunting and wasting particularly during the first 6 months of HAART is necessary. Nutritional intervention may also benefit survival.
| Item Type: | Thesis (Masters) |
|---|---|
| Subjects: | R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine R Medicine > RJ Pediatrics > RJ101 Child Health. Child health services |
| Divisions: | Africana |
| Depositing User: | Emmanuel Ndorimana |
| Date Deposited: | 24 Jul 2018 08:03 |
| Last Modified: | 24 Jul 2018 08:03 |
| URI: | http://thesisbank.jhia.ac.ke/id/eprint/8053 |
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