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- Title
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.
- Authors
Aemro, Agazhe; Wassie, Mulugeta; Chekol, Basazinew
- Abstract
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.
- Subjects
SUB-Saharan Africa; ETHIOPIA; AIDS; FOLLOW-up studies (Medicine); ANTIRETROVIRAL agents; FORECASTING; ADULTS
- Publication
PLoS ONE, 2021, Vol 16, Issue 5, p1
- ISSN
1932-6203
- Publication type
Article
- DOI
10.1371/journal.pone.0251648