Incidence and predictors of tuberculosis occurrence among adults on antiretroviral therapy at Debre Markos referral hospital, Northwest Ethiopia: retrospective follow-up study

Aemro, Agazhe; Ferede, Abebaw; Anlay, Degefaye Zelalem

doi:10.1186/s12879-020-04959-y

Cited by 15 publications

(20 citation statements)

References 24 publications

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“…Similarly, in this study, patients’ functional status at baseline was found to be the predictor of TB co-infection free survival time of HIV/AIDS patients. This result is consistent with the report of the study conducted by Aemro et al at Debra Markos referral hospital, Northwest Ethiopia 47 . Accorging to our study, patient with bedridden functional status at baseline had shorter TB co-infection free survival time compared to patients with working functional status at baseline.…”

Section: Discussionsupporting

confidence: 93%

Bayesian parametric modeling of time to tuberculosis co-infection of HIV/AIDS patients at Jimma Medical Center, Ethiopia

Umeta

Yermosa

Dufera

2022

Sci Rep

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Tuberculosis is the most common opportunistic infection among HIV/AIDS patients, including those following Antiretroviral Therapy treatment. The risk of tuberculosis infection is higher in people living with HIV/AIDS than in people who are free from HIV/AIDS. Many studies focused on prevalence and determinants of tuberculosis in HIV/AIDS patients without taking into account the censoring aspects of the time to event data. Therefore, this study was undertaken with aim to model time to tuberculosis co-infection of HIV/AIDS patients under follow-up at Jimma Medical Center, Ethiopia using Bayesian parametric survival models. A data of a retrospective cohort of 421 HIV/AIDS patients under follow-up from January 2016 to December 2020 until active tuberculosis was diagnosed or until the end of the study was collected from Jimma Medical Center, Ethiopia. The analysis of the data was performed using R-INLA software package. In order to identify the risk factors which have association with tuberculosis co-infection survival time, Bayesian parametric accelerated failure time survival models were fitted to the data using Integrated Nested Laplace Approximation methodology. About 26.37% of the study subjects had been co-infected with tuberculosis during the study period. Among the parametric accelerated failure time models, the Bayesian log-logistic accelerated failure time model was found to be the best fitting model for the data. Patients who lived in urban areas had shorter tuberculosis co-infection free survival time compared to those who lived in rural areas with an acceleration factor of 0.2842. Patients who smoke and drink alcohol had also shorter tuberculosis co-infection survival time than those who do not smoke and drink alcohol respectively. Patients with advanced WHO clinical stages(Stage III and IV), bedridden functional status, low body mass index and severe anemic status had shorter tuberculosis co-infection survival time. Place of residence, smoking, drinking alcohol, larger family size, advanced clinical stages(Stage III and Stage IV), bedridden functional status, CD4 count ($$\le $$ ≤ 200 cells/mm3 and 200–349 cells/mm3), low body mass index and low hemoglobin are the factors that lead to shorter tuberculosis co-infection survival time in HIV/AIDS patients. The findings of the study suggested us to forward the recommendations to modify patients’ life style, early screening and treatment of opportunistic diseases like anemia , as well as effective treatment and management of tuberculosis and HIV co-infection are important to prevent tuberculosis and HIV co-infection.

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Section: Discussionsupporting

confidence: 93%

Bayesian parametric modeling of time to tuberculosis co-infection of HIV/AIDS patients at Jimma Medical Center, Ethiopia

Umeta

Yermosa

Dufera

2022

Sci Rep

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“…Similarly, in this study, patients' functional status at baseline was found to be the predictor of TB co-infection free survival time of HIV/AIDS patients. This result is consistent with the report of the study conducted by Aemro et al at Debra Markos referral hospital, Northwest Ethiopia [64]. Accorging to our study, patient with bedridden functional status at baseline had shorter TB co-infection free survival time compared to patients with working functional status at baseline.…”

Section: Discussionsupporting

confidence: 93%

Bayesian Parametric Modeling of Time to Tuberculosis Co-Infection of HIV/AIDS Patients Under Antiretroviral Therapy Treatment at Jimma University Medical Center, Ethiopia

Umeta

Yermosa

Dufera

2021

Preprint

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Background: Tuberculosis is the most common opportunistic infection among HIV/AIDS patients, including those following Antiretroviral Therapy treatment. The risk of Tuberculosis infection is higher in people living with HIV/AIDS than in people who are free from HIV/AIDS. Many studies focused on prevalence and determinants of Tuberculosis in HIV/AIDS patients without taking into account the censoring aspects of the time to event data. Therefore, this study was undertaken with aim to model time to Tuberculosis co-infection of HIV/AIDS patients following Antiretroviral Therapy treatment using Bayesian parametric survival models.Methods: A data of a retrospective cohort of HIV/AIDS patients under Antiretroviral Therapy treatment follow-up from January 2016 to December 2020 until Tuberculosis was clinically diagnosed or until the end of the study was collected from Antiretroviral Therapy treatment center of Jimma University Medical Center, Ethiopia. In order to identify the risk factors which have association with Tuberculosis co-infection survival time, Bayesian parametric Accelerated failure time survival models were fitted to the data using Integrated Nested Laplace Approximation methodology.Results: About 26.37% of the study subjects had been co-infected with tuberculosis during the study period. Among the parametric Accelerated failure time models, the Bayesian log-logistic Accelerated failure time model was found to be the best fitting model for the data.Conclusions: Tuberculosis co-infection survival time was significantly associated with place of residence, smoking, drinking alcohol, family size, WHO clinical stages, functional status, CD4 count, BMI and hemoglobin level. The finding of this study provide timely information on the risk factors associated with TB co-infection survival time for healthy policy makers and planners.

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“…Functional status of patients. Classified according to the WHO criteria as working(W): capably of going out of home and do routine activities including the daily work; Ambulatory (A): capable of self-care and going to the toilet unsupported; Bed-ridden (B): cannot go even to the toilet unsupported [25].…”

Section: Operational Definitionmentioning

confidence: 99%

Incidence and predictors of mortality within the first year of antiretroviral therapy initiation at Debre-Markos Referral Hospital, Northwest Ethiopia: A retrospective follow up study

2021

Self Cite

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Background Acquired Immunodeficiency Syndrome (AIDS) is one of the most fatal infectious diseases in the world, especially in Sub-Saharan Africa, including Ethiopia. Even though Antiretroviral therapy (ART) significantly decreases mortality overall, death rates are still highest especially in the first year of ART initiation. Objective To assess the incidence and predictors of mortality within the first year of ART initiation among adults on ART at Debre-Markos Referral Hospital, Northwest Ethiopia. Methods A retrospective follow-up study was conducted among 514 newly enrolled adults to ART from 2014 to 2018 at Debre-Markos Referral Hospital. Patients’ chart number was selected from the computer using a simple random sampling technique. Data were entered into EPI- INFO 7.2.2.6 and analyzed using Stata 14.0. The mortality rate within the first year was computed and described using frequency tables. Both bivariable and multivariable Cox-proportional hazard models were fitted to show predictors of early mortality. Results Out of 494 patient records included in the analysis, a total of 54 deaths were recorded within one year follow-up period. The overall mortality rate within 398.37 person years (PY) was 13.56 deaths/100 PY with the higher rate observed within the first three months. After adjustment, rural residence (Adjusted Hazard Ratio (AHR) = 1.97; 95% CI: 1.05–3.71), ≥ 6 months pre-ART duration (AHR = 2.17; 95% CI: 1.24–3.79), ambulatory or bedridden functional status at enrolment (AHR = 2.18; 95% CI: 1.01–4.74), and didn’t take Cotrimoxazole preventive therapy (CPT) during follow-up (AHR = 1.88; 95% CI: 1.04–3.41) were associated with early mortality of adults on ART. Conclusion Mortality within the first year of ART initiation was high and rural residence, longer pre-Art duration, ambulatory or bedridden functional status and didn’t take CPT during follow-up were found to be independent predictors. Hence, giving special attention for patients from rural area and provision of CPT is crucial to reduce mortality.

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Incidence and predictors of tuberculosis occurrence among adults on antiretroviral therapy at Debre Markos referral hospital, Northwest Ethiopia: retrospective follow-up study

Abstract: Background: In resource limited settings, Tuberculosis (TB) is a major cause of morbidity and mortality among patients on antiretroviral treatment. Ethiopia is one of the 30 high TB burden countries. TB causes burden in healthcare system and challenge the effectiveness of HIV care.

Cited by 15 publications

References 24 publications

Bayesian parametric modeling of time to tuberculosis co-infection of HIV/AIDS patients at Jimma Medical Center, Ethiopia

Bayesian parametric modeling of time to tuberculosis co-infection of HIV/AIDS patients at Jimma Medical Center, Ethiopia

Bayesian Parametric Modeling of Time to Tuberculosis Co-Infection of HIV/AIDS Patients Under Antiretroviral Therapy Treatment at Jimma University Medical Center, Ethiopia

Incidence and predictors of mortality within the first year of antiretroviral therapy initiation at Debre-Markos Referral Hospital, Northwest Ethiopia: A retrospective follow up study

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