Abstract
Introduction: Survival is low among non-treated patients. The time to survive after ART initiation has not been adequately studied. Thus, this study was aimed to determine survival status and associated factors among HIV positive adults on antiretroviral treatment in Debre Markos Referral Hospital, Northwest Ethiopia. Methods: Facility-based retrospective cohort study design was conducted from September to February 2013. Data were collected from 640 patients' registration card in Debre Markos Referral Hospital who enrolled for treatment from 2005 to 2013. Kaplan-Meier survival curves and Log-Rank test were used to compare the survival times of different groups of patients. Results: A total of 640 patients followed for median of 58 months and 261 patients died during the follow up period. Over all estimated mean survival times of patients was 65.22 (95%CI: 61.409-69.043) months after initiation of treatment. Baseline hemoglobin <10g/mm3, (AHR=1.869, 95%CI: 1.319-2.649), baseline ambulatory functional status (AHR=2.727, 95%CI: 1.905-3.905), bedridden functional status (AHR=2.382, 95%CI: 1.326-4.279), baseline WHO staging III and IV (AHR=2.164, 95%CI: 1.101-4.258), recent ART adherence (AHR: 2.169, 95%CI: 1.030-4.567) and fair adherence (AHR=1.887, 95%CI: 1.081-3.295) were associated with survival of the patients. Conclusion: The Kaplan-Meier results showed that the general mean estimated survival time of patients after Highly Active Anti Retroviral Therapy (HAART) initiation was improved. But low baseline hemoglobin, ill-health functional status, poor ART adherence were negatively associated with lesser survival of patients.
Highlights
An estimated 34 million people were living with HIV at the end of 2010 [1]
Study population All HIV positive adults' record in Debre Markos Referral Hospital who were on antiretroviral therapy enrolled to treatment from 30th September 2005 to 30thFebruary 2013 were the source population and selected HIV positive adults' record on care and support follow up who had started Antiretroviral Therapy (ART) at the hospital within the same period were included in the study
Between September 19, 2005 to January 30, 2008, 5122 HIV patients ever enrolled to Debre Markos Referral Hospital from which 2604 were on ART
Summary
An estimated 34 million people were living with HIV at the end of 2010 [1]. About 68% of all people living with HIV resided in sub-Saharan Africa, a region with only 12% of the global population in 2010 [5]. Ethiopia is among the seriously affected countries in sub Saharan Africa with more than 1.3 million people living with HIV and an estimated 277,800 people requiring treatment [1]. Study of the outcome of ART so as to provide necessary information to healthcare providers, policy makers and program funders to determine resource allocation and optimize care and treatment strategies for HIV in Ethiopia is timely issue. This study was aimed to determine the survival status and its predictors among HIV positive adults on ART in Debre Markos Referral Hospital, Northwest Ethiopia, and 2005-2013
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