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Predictors of Mortality among Patients Enrolled on Antiretroviral Therapy in Aksum Hospital, Northern Ethiopia: A Retrospective Cohort Study

BACKGROUND: Since launching of antiretroviral (ART) treatment, the numbers of patients enrolled in to ART are increasing in many developing countries. But many studies done across Africa including Ethiopia on antiretroviral therapy programs have shown higher mortality at the first six months of trea...

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Autores principales: Tadesse, Kidane, Haile, Fisaha, Hiruy, Neway
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3909114/
https://www.ncbi.nlm.nih.gov/pubmed/24498093
http://dx.doi.org/10.1371/journal.pone.0087392
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author Tadesse, Kidane
Haile, Fisaha
Hiruy, Neway
author_facet Tadesse, Kidane
Haile, Fisaha
Hiruy, Neway
author_sort Tadesse, Kidane
collection PubMed
description BACKGROUND: Since launching of antiretroviral (ART) treatment, the numbers of patients enrolled in to ART are increasing in many developing countries. But many studies done across Africa including Ethiopia on antiretroviral therapy programs have shown higher mortality at the first six months of treatment initiation. But the factors associated with this high mortality are poorly characterized. So this study aims to determine mortality and identify predictors of it among patients on ART. METHODS: Retrospective cohort study was employed among a total of 520 records of patients who were enrolled on antiretroviral therapy in Aksum hospital from September 2006 to August 2011. Baseline patient records were extracted from electronic and paper based medical records database and analysed using Kaplan Meier survival and Cox proportional hazard model to identify the independent predictors of mortality of patients on ART. RESULTS: A total of 46 (8.85%) deaths was observed giving an overall mortality rate of 3.2 per 100 person-years. The independent predictor of mortality identified for this cohort were haemoglobin level <11 mg/dl (Hazard Ratio (HR) = 1.9, 95%-CI = 1.01, 3.52), CD4 cell counts lower than 50 cells/µl (HR = 2.1, 95%- CI = 1.13,3.89), Male gender (HR = 1.9, 95%-CI = 1.01,3.52), Weight <40 kg (HR = 2.3,95% CI = 1.24,4.55), primary level of education and lower (HR = 2.6, 95%- CI = 1.29,5.55). CONCLUSIONS: The over all mortality of adults patients on ART was low but higher in the early months of ART initiation. low levels of haemoglobin <11 gm/dl, lower CD4 cell count, male gender, weight <40 Kg and individuals who have primary level of education and lower were indentified as the independent predictors of mortality. For this reason, early initiation of ART despite the CD4 count and method of HIV diagnosis, nutritional support and close monitoring of patients in the early periods of ART treatment initiation is very crucial to improve patient survival.
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spelling pubmed-39091142014-02-04 Predictors of Mortality among Patients Enrolled on Antiretroviral Therapy in Aksum Hospital, Northern Ethiopia: A Retrospective Cohort Study Tadesse, Kidane Haile, Fisaha Hiruy, Neway PLoS One Research Article BACKGROUND: Since launching of antiretroviral (ART) treatment, the numbers of patients enrolled in to ART are increasing in many developing countries. But many studies done across Africa including Ethiopia on antiretroviral therapy programs have shown higher mortality at the first six months of treatment initiation. But the factors associated with this high mortality are poorly characterized. So this study aims to determine mortality and identify predictors of it among patients on ART. METHODS: Retrospective cohort study was employed among a total of 520 records of patients who were enrolled on antiretroviral therapy in Aksum hospital from September 2006 to August 2011. Baseline patient records were extracted from electronic and paper based medical records database and analysed using Kaplan Meier survival and Cox proportional hazard model to identify the independent predictors of mortality of patients on ART. RESULTS: A total of 46 (8.85%) deaths was observed giving an overall mortality rate of 3.2 per 100 person-years. The independent predictor of mortality identified for this cohort were haemoglobin level <11 mg/dl (Hazard Ratio (HR) = 1.9, 95%-CI = 1.01, 3.52), CD4 cell counts lower than 50 cells/µl (HR = 2.1, 95%- CI = 1.13,3.89), Male gender (HR = 1.9, 95%-CI = 1.01,3.52), Weight <40 kg (HR = 2.3,95% CI = 1.24,4.55), primary level of education and lower (HR = 2.6, 95%- CI = 1.29,5.55). CONCLUSIONS: The over all mortality of adults patients on ART was low but higher in the early months of ART initiation. low levels of haemoglobin <11 gm/dl, lower CD4 cell count, male gender, weight <40 Kg and individuals who have primary level of education and lower were indentified as the independent predictors of mortality. For this reason, early initiation of ART despite the CD4 count and method of HIV diagnosis, nutritional support and close monitoring of patients in the early periods of ART treatment initiation is very crucial to improve patient survival. Public Library of Science 2014-01-31 /pmc/articles/PMC3909114/ /pubmed/24498093 http://dx.doi.org/10.1371/journal.pone.0087392 Text en © 2014 Tadesse et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Tadesse, Kidane
Haile, Fisaha
Hiruy, Neway
Predictors of Mortality among Patients Enrolled on Antiretroviral Therapy in Aksum Hospital, Northern Ethiopia: A Retrospective Cohort Study
title Predictors of Mortality among Patients Enrolled on Antiretroviral Therapy in Aksum Hospital, Northern Ethiopia: A Retrospective Cohort Study
title_full Predictors of Mortality among Patients Enrolled on Antiretroviral Therapy in Aksum Hospital, Northern Ethiopia: A Retrospective Cohort Study
title_fullStr Predictors of Mortality among Patients Enrolled on Antiretroviral Therapy in Aksum Hospital, Northern Ethiopia: A Retrospective Cohort Study
title_full_unstemmed Predictors of Mortality among Patients Enrolled on Antiretroviral Therapy in Aksum Hospital, Northern Ethiopia: A Retrospective Cohort Study
title_short Predictors of Mortality among Patients Enrolled on Antiretroviral Therapy in Aksum Hospital, Northern Ethiopia: A Retrospective Cohort Study
title_sort predictors of mortality among patients enrolled on antiretroviral therapy in aksum hospital, northern ethiopia: a retrospective cohort study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3909114/
https://www.ncbi.nlm.nih.gov/pubmed/24498093
http://dx.doi.org/10.1371/journal.pone.0087392
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