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Risk Factors for Mortality among Adult HIV/AIDS Patients Following Antiretroviral Therapy in Southwestern Ethiopia: An Assessment through Survival Models

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Listed:
  • Dinberu Seyoum

    (Institute of Health and Society (IRSS), Université catholique de Louvain, Brussels B-1082, Belgium
    Department of Statistics, Natural Science College, Jimma University, Jimma, PO Box 378, Ethiopia)

  • Jean-Marie Degryse

    (Institute of Health and Society (IRSS), Université catholique de Louvain, Brussels B-1082, Belgium
    Department Public Health and Primary Care, KU Leuven, Leuven B-3000, Belgium)

  • Yehenew Getachew Kifle

    (Department of Statistics and Operations Research, University of Limpopo, Sovenga, 0727, South Africa)

  • Ayele Taye

    (School of Mathematical and Statistical Science, Hawassa University, P.O. Box 05, Ethiopia)

  • Mulualem Tadesse

    (Department of Medical Laboratory Sciences and Pathology, College of Health Sciences, Jimma University, Jimma, P.O. Box 378, Ethiopia)

  • Belay Birlie

    (Department of Statistics, Natural Science College, Jimma University, Jimma, PO Box 378, Ethiopia)

  • Akalu Banbeta

    (Department of Statistics, Natural Science College, Jimma University, Jimma, PO Box 378, Ethiopia)

  • Angel Rosas-Aguirre

    (Institute of Health and Society (IRSS), Université catholique de Louvain, Brussels B-1082, Belgium
    Institute of Tropical Medicine “Alexander von Humboldt”, Universidad Peruana Cayetano Heredia, Lima 15000, Peru)

  • Luc Duchateau

    (Department of Comparative Physiology and Biometrics, Ghent University, Ghent B-9000, Belgium)

  • Niko Speybroeck

    (Institute of Health and Society (IRSS), Université catholique de Louvain, Brussels B-1082, Belgium)

Abstract

Introduction: Efforts have been made to reduce HIV/AIDS-related mortality by delivering antiretroviral therapy (ART) treatment. However, HIV patients in resource-poor settings are still dying, even if they are on ART treatment. This study aimed to explore the factors associated with HIV/AIDS-related mortality in Southwestern Ethiopia. Method: A non-concurrent retrospective cohort study which collected data from the clinical records of adult HIV/AIDS patients, who initiated ART treatment and were followed between January 2006 and December 2010, was conducted, to explore the factors associated with HIV/AIDS-related mortality at Jimma University Specialized Hospital (JUSH). Survival times (i.e., the time from the onset of ART treatment to the death or censoring) and different characteristics of patients were retrospectively examined. A best-fit model was chosen for the survival data, after the comparison between native semi-parametric Cox regression and parametric survival models (i.e., exponential, Weibull, and log-logistic). Result: A total of 456 HIV patients were included in the study, mostly females (312, 68.4%), with a median age of 30 years (inter-quartile range (IQR): 23–37 years). Estimated follow-up until December 2010 accounted for 1245 person-years at risk (PYAR) and resulted in 66 (14.5%) deaths and 390 censored individuals, representing a median survival time of 34.0 months ( IQR: 22.8–42.0 months). The overall mortality rate was 5.3/100 PYAR: 6.5/100 PYAR for males and 4.8/100 PYAR for females. The Weibull survival model was the best model for fitting the data (lowest AIC). The main factors associated with mortality were: baseline age (>35 years old, AHR = 3.8, 95% CI: 1.6–9.1), baseline weight (AHR = 0.93, 95% CI: 0.90–0.97), baseline WHO stage IV (AHR = 6.2, 95% CI: 2.2–14.2), and low adherence to ART treatment (AHR = 4.2, 95% CI: 2.5–7.1). Conclusion: An effective reduction in HIV/AIDS mortality could be achieved through timely ART treatment onset and maintaining high levels of treatment adherence.

Suggested Citation

  • Dinberu Seyoum & Jean-Marie Degryse & Yehenew Getachew Kifle & Ayele Taye & Mulualem Tadesse & Belay Birlie & Akalu Banbeta & Angel Rosas-Aguirre & Luc Duchateau & Niko Speybroeck, 2017. "Risk Factors for Mortality among Adult HIV/AIDS Patients Following Antiretroviral Therapy in Southwestern Ethiopia: An Assessment through Survival Models," IJERPH, MDPI, vol. 14(3), pages 1-12, March.
    • Handle: RePEc:gam:jijerp:v:14:y:2017:i:3:p:296-:d:92865
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    References listed on IDEAS

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    1. Kidane Tadesse & Fisaha Haile & Neway Hiruy, 2014. "Predictors of Mortality among Patients Enrolled on Antiretroviral Therapy in Aksum Hospital, Northern Ethiopia: A Retrospective Cohort Study," PLOS ONE, Public Library of Science, vol. 9(1), pages 1-6, January.
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