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Logo of aidsrestherBioMed CentralBiomed Central Web Sitesearchsubmit a manuscriptregisterthis articleAIDS Research and Therapy
 
AIDS Res Ther. 2012; 9: 15.
Published online 2012 May 18. doi:  10.1186/1742-6405-9-15
PMCID: PMC3403909
Copyright ©2012 Biadgilign et al.; licensee BioMed Central Ltd.
Predictors of mortality among HIV infected patients taking antiretroviral treatment in Ethiopia: a retrospective cohort study
Sibhatu Biadgilign,1 Ayalu A Reda,corresponding author2 and Tesfaye Digaffe3
1Department of Epidemiology and Biostatistics, College of Medical and Health Science, Jimma University, Jimma, Ethiopia
2Department of Public Health, College of Health Sciences, Haramaya University, P. O. Box 235, Harar, Ethiopia
3Department of Medical Laboratory Science, College of Health Sciences, Harar, Ethiopia
corresponding authorCorresponding author.
Sibhatu Biadgilign: sibhatu2010/at/gmail.com; Ayalu A Reda: ayaluaklilu/at/yahoo.com; Tesfaye Digaffe: tdigaffe/at/yahoo.com
Received March 2, 2012; Accepted May 18, 2012.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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Abstract
Background
Studies indicate that there is high early mortality among patients starting antiretroviral treatment in sub-Saharan Africa. However, there is paucity of evidence on long term survival of patients on anti-retroviral treatment in the region. The objective of this study is to examine mortality and its predictors among a cohort of HIV infected patients on anti-retroviral treatment retrospectively followed for five years.
Methods
A retrospective cohort study was conducted among HIV infected patients on ART in eastern Ethiopia. Cox regression and Kaplan-Meier analyses were performed to investigate factors that influence time to death and survival over time.
Result
A total of 1540 study participants were included in the study. From the registered patients in the cohort, the outcome of patients as active, deceased, lost to follow up and transfer out was 1005 (67.2%), 86 (5.9%), 210 (14.0%) and 192 (12.8%) respectively. The overall mortality rate provides an incidence density of 2.03 deaths per 100 person years (95% CI 1.64 - 2.50). Out of a total of 86 deaths over 60 month period; 63 (73.3%) died during the first 12 months, 10 (11.6%) during the second year, and 10 (11.6%) in the third year of follow up. In multivariate analysis, the independent predictors for mortality were loss of more 10% weight loss, bedridden functional status at baseline, ≤ 200 CD4 cell count/ml, and advanced WHO stage patients.
Conclusion
A lower level of mortality was detected among the cohort of patients on antiretroviral treatment in eastern Ethiopia. Previous history of weight loss, bedridden functional status at baseline, low CD4 cell count and advanced WHO status patients had a higher risk of death. Early initiation of ART, provision of nutritional support and strengthening of the food by prescription initiative, and counseling of patients for early presentation to treatment is recommended.
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