Survival status and predictors of mortality among HIV-positive children initiated antiretroviral therapy in Bahir Dar town public health facilities Amhara region, Ethiopia, 2020

Abstract

Background: Although there is a presence of governmental and non-governmental organizations running to provide quality HIV care services to reduce HIV-related mortality, there is rapid disease progression and death among children in developing countries including Ethiopia. Thus, this study was aimed to assess the mortality predictors of children living with HIV at Bahir Dar town public health facilities. Method: A facility-based retrospective follow-up study was conducted among 588 children who were enrolled in the HIV care clinic from 1 September 2010 to 30 August 2019. Data were entered into the Epi-Data entry 3.1 and then exported to STATA version 14 for analysis. Multiple imputation models were employed to handle missing data using the multivariate imputation Chained Equations technique. The Kaplan–Meier survival curve and log-rank test were used to estimate and compare the survival time of categorical variables. Result: About 27 (4.6%) (95% confidence interval: 2.9–6.5) deaths were observed from the 30,062.3 person-months follow-up period, and the overall incidence density rate of 0.9 per 1000 child-months (95% confidence interval: 0.6–1.3). Advanced WHO clinical stage (adjusted hazard ratio = 3.18; 95% confidence interval: 1.07–9.43), hemoglobin level less than 8 g/dL (adjusted hazard ratio = 3.54; 95% confidence interval: 1.27–8.85), children having a weight for age of <−2z (adjusted hazard ratio = 2.81; 95% confidence interval: 1.19–6.6), children with poor adherence (adjusted hazard ratio = 3.91; 95% confidence interval: 1.41–10.8), and starting the treatment beyond 1 week of being eligible (adjusted hazard ratio = 3.22; 95% confidence interval: 1.21–8.53) were predictors of HIV-related mortality among children initiated antiretroviral therapy. Conclusion: The hazard of mortality was higher among HIV-infected children in the early period of initiation. Enhancing antiretroviral therapy drug adherence, monitoring Hgb level, and timely initiation of antiretroviral therapy reduce HIV-related mortality.

Survival and predictors of mortality among HIV-infected adults after initiation of Anti-Retroviral Therapy in Eastern Ethiopia

“…The hazard of death among HIV-positive patients was higher on the fair and poor level of the last known(recent) adherence level compared with those who have a good level of adherence. This nding is in agreement with other similar studies (17)(18)(19)22,23,(25)(26)(27). Non-adherence to the care and medication becomes less commitment to the treatment and leads to non-retain in the care, and then the patient interrupts the treatment and may develop treatment failure and opportunistic infection (12).…”

“…The nding from the current study belongs to higher than other studies conducted in Indian public hospitals (23), Nekemte Ethiopia (22). But some studies reported the higher nding of incidence rates compared with the current ndings (4,15,19,20,25,26). This discrepancy in results and the variation in mortality rates between these studies may be due to differences in the clinical characteristics of study participants and differences in study periods (length of follow-up), sample sizes and study settings, as our study included multi-center involvement and we included the patients those who started ART after test and treat strategy.…”

“…The proportions of AIDS-related mortality vary between African countries ranging from 4.5-29.7%. Ethiopia is also among the high burden of HIV/AIDS-related mortality reported that 11.8% in the current study (5,(15)(16)(17)(18)(19)(20).…”

“…According to the prior studies report the overall incidence rate for mortality have been ranged from 1.89 per 100 person year observation to 13.56 per 100 person year observation (5,16,(21)(22)(23)(24)(25)(26)(27). The previous studies reported important predictors of mortality like socio-demographic, treatment, and clinical related factors that sex (5,20,28,29), age (21,22,25,28,30), place of residence (4,5), anemia status (16,19,20,22,26,31), disclosure status (15), functional status (4,5,(15)(16)(17)(18)27), adherence level (16,18,19,22,23,26,27), World health organization(WHO) clinical stage (16,20,25,26,32,33), baseline opp...…”

Virological Non-Suppression among Newly Diagnosed HIV-Positive Individuals on Dolutegravir-Based Antiretroviral Treatment in Eastern Ethiopia: Follow-Up Study

“…The estimated pooled prevalence of virological non-suppression among PLHIV in sub-Saharan Africa is 17.25% [ 6 ]. Nevertheless, the degree of virological non-suppression varies across nations and study populations, with 34% in central Tanzania [ 7 ] and 9–17% in various parts of Ethiopia—9% in Adama [ 8 ], 11% in Jimma [ 9 ], 12.2% in Delgi [ 10 ], 12.5% in the Amhara region [ 11 ], 14.5% in Adigrat [ 12 ], and 16.6% in Sekota [ 13 ].…”