Ann Infect Dis Epidemiol | Volume 5, Issue 1 | Research Article | Open Access
Kebede Embaye Gezae1*, Haftom Temesgen Abebe1, Letekirstos Gebreegziabher Gebretsadik1 and Abrha Kidu Gebremeskel2
1Department of Biostatistics, Mekelle University, Ethiopia
2Department of Water Resources and Irrigation Engineering, Aksum University (Shire Campus), Ethiopia
*Correspondance to: Kebede Embaye Gezae
Fulltext PDFBackground: Ethiopia is a country with high burden of Tuberculosis and Human Immunodeficiency Virus (TB-HIV) dual infections in the world. However, little was known so far on predictors of time to death among TB/HIV co-infected adults in the study setting in particular. Therefore, this study was aimed at filling this gap in the region particularly. Methods: A hospital based retrospective cohort study design was employed on 305 Tuberculosis and Human Immunodeficiency Virus (TB/HIV) co-infected adults who have started Anti-Retroviral Therapy (ART) from January, 2009 to December, 2016 at two governmental hospitals in Mekelle, Ethiopia. Multivariable Cox regression analysis was applied to identify statistically significant predictors of time to death (P< 0.05). Finally, Adjusted Hazard Ratio (AHR) and 95% Confidence Interval (CI) were interpreted and reported in the final Cox model. Results: Overall, 70 of 305 (23.0%) TB/HIV co-infected adults were died during the entire follow-up period. The study subjects (257 Active TB, 48 Latent TB) were followed for an overall median follow up time of 37 months (Interquartile Range: 10 to 63 months). Baseline Body Mass Index (<18.5 kg/ m2) (AHR=2.427; 95% CI: 1.214 to 4.853), and Being Extra-pulmonary TB (Mixed TB) patient (AHR=2.400; 95% CI: 0.220 to 0.697) were predictors of time to death. On the other hand, increasing CD4 cell count (AHR=0.995; 95% CI: 0.991 to 0.999), developing drug side effects (AHR=0.369; 95% CI: 0.194 to 0.701), being co-infected with Latent TB infection (AHR=0.102; 95% CI: 0.023 to 0.449), completing TB treatment (AHR=0.114; 95% CI: 0.060 to 0.16), and being on Cotri-moxazole Prophylactic Therapy (AHR=0.391; 95% CI: 0.220 to 0.697) had prolonged the time to death. Conclusion: Almost one-fourth of TB/HIV co-infected patients were died with a relatively high mortality rate among those co-infected with active TB since ART initiation. Moreover, being co-infected with active TB/HIV, having low baseline BMI (< 18.5 g/dl), Low CD4 cell count, not developing drug side effects, being on TB treatment, and being off CPT were shortening the time to death and thus, survival of TB-HIV co-infected adults will be improved up on switching off the potential risk factors identified.
Adults; Time to death; TB/HIV; ART; AIDS; CD4
Gezae KE, Abebe HT, Gebretsadik LG, Gebremeskel AK. Predictors of Time to Death among TB/HIV Co-Infected Adults on ART at Two Governmental Hospitals in Mekelle, Ethiopia, 2009- 2016: A Retrospective Cohort Study. Ann Infect Dis Epidemiol. 2020; 5(1): 1049.