Mortality rate among HIV-positive children on ART in Northwest Ethiopia: a historical cohort study
Abstract Background Though highly active antiretroviral therapy (HAART) has been available for more than a decade in Ethiopia, information regarding mortality rates of human immunodeficiency virus (HIV)-positive children after antiretroviral therapy antiretroviral therapy (ART) initiation is very sc...
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| Format: | Article |
| Language: | English |
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BMC
2020-08-01
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| Series: | BMC Public Health |
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| Online Access: | http://link.springer.com/article/10.1186/s12889-020-09418-6 |
| _version_ | 1818145186453127168 |
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| author | Animut Alebel Eshetu Haileselassie Engeda Mengistu Mekonnen Kelkay Pammla Petrucka Getiye Dejenu Kibret Fasil Wagnew Getnet Asmare Zebenay Workneh Bitew Daniel Bekele Ketema Getnet Gedif Belisty Temesgen Yitbarek Tenaw Hibstie Mamaru Wubale Melkamu Setegn Eshetie |
| author_facet | Animut Alebel Eshetu Haileselassie Engeda Mengistu Mekonnen Kelkay Pammla Petrucka Getiye Dejenu Kibret Fasil Wagnew Getnet Asmare Zebenay Workneh Bitew Daniel Bekele Ketema Getnet Gedif Belisty Temesgen Yitbarek Tenaw Hibstie Mamaru Wubale Melkamu Setegn Eshetie |
| author_sort | Animut Alebel |
| collection | DOAJ |
| description | Abstract Background Though highly active antiretroviral therapy (HAART) has been available for more than a decade in Ethiopia, information regarding mortality rates of human immunodeficiency virus (HIV)-positive children after antiretroviral therapy antiretroviral therapy (ART) initiation is very scarce. Thus, this study intends to determine the predictors of mortality among HIV-positive children receiving ART in Amhara Region. Methods A multicenter facility-based historical cohort study was conducted in 538 HIV-positive children on ART from January 2012 to February 2017. We employed a standardized data extraction tool, adapted from ART entry and follow-up forms. Descriptive analyses were summarized using the Kaplan-Meier survival curve and log rank test. Then, the Cox-proportional hazard regression model was employed to estimate the hazard of death up to five-years after ART initiation. Variables with p-values ≤0.25 in bivariable analysis were candidates to the multivariable analysis. Finally, variables with p-values < 0.05 were considered as significant variables. Results The cohort contributed a total follow-up time of 14,600 child-months, with an overall mortality rate of 3.2 (95% CI: 2.3, 4.3) per 100 child-years. This study also indicated that HIV-infected children presenting with opportunistic infections (OIs) (AHR: 2.5, 95% CI: 1.04, 5.9), anemia (AHR: 3.1, 95% CI: 1.4, 6.7), severe immunodeficiency (AHR: 4.4, 95% CI: 1.7, 11.7), severe stunting (AHR: 3.3, 95% CI: 1.4, 8.0), severe wasting (AHR: 3.1, 95% CI: 1.3, 7.3), and advanced disease staging (III and IV) (AHR: 3.0, 95% CI: 1.2, 7.1) were at higher risk of mortality. Conclusion A higher rate of mortality was observed in our study as compared to previous Ethiopian studies. HIV-positive children presenting with anemia, OIs, severe immunodeficiency, advanced disease staging (III and IV), severe stunting, and severe wasting were at higher risk of mortality. |
| first_indexed | 2024-12-11T11:59:27Z |
| format | Article |
| id | doaj.art-2417185b71234625a7c79bd4fc2f387d |
| institution | Directory Open Access Journal |
| issn | 1471-2458 |
| language | English |
| last_indexed | 2024-12-11T11:59:27Z |
| publishDate | 2020-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Public Health |
| spelling | doaj.art-2417185b71234625a7c79bd4fc2f387d2022-12-22T01:08:07ZengBMCBMC Public Health1471-24582020-08-0120111110.1186/s12889-020-09418-6Mortality rate among HIV-positive children on ART in Northwest Ethiopia: a historical cohort studyAnimut Alebel0Eshetu Haileselassie Engeda1Mengistu Mekonnen Kelkay2Pammla Petrucka3Getiye Dejenu Kibret4Fasil Wagnew5Getnet Asmare6Zebenay Workneh Bitew7Daniel Bekele Ketema8Getnet Gedif9Belisty Temesgen10Yitbarek Tenaw Hibstie11Mamaru Wubale Melkamu12Setegn Eshetie13College of Health Science, Debre Markos UniversityCollege of Medicine and Health Sciences, University of GondarCollege of Medicine and Health Sciences, University of GondarCollege of Nursing, University of SaskatchewanCollege of Health Science, Debre Markos UniversityCollege of Health Science, Debre Markos UniversityDebre Tabor University, College of Health SciencesDepartment of Nursing, St. Paul’s Hospital Millennium Medical CollegeCollege of Health Science, Debre Markos UniversityCollege of Health Science, Debre Markos UniversityDebre Markos Referral HospitalDebre Markos Referral HospitalDebre Markos Referral HospitalCollege of Medicine and Health Sciences, University of GondarAbstract Background Though highly active antiretroviral therapy (HAART) has been available for more than a decade in Ethiopia, information regarding mortality rates of human immunodeficiency virus (HIV)-positive children after antiretroviral therapy antiretroviral therapy (ART) initiation is very scarce. Thus, this study intends to determine the predictors of mortality among HIV-positive children receiving ART in Amhara Region. Methods A multicenter facility-based historical cohort study was conducted in 538 HIV-positive children on ART from January 2012 to February 2017. We employed a standardized data extraction tool, adapted from ART entry and follow-up forms. Descriptive analyses were summarized using the Kaplan-Meier survival curve and log rank test. Then, the Cox-proportional hazard regression model was employed to estimate the hazard of death up to five-years after ART initiation. Variables with p-values ≤0.25 in bivariable analysis were candidates to the multivariable analysis. Finally, variables with p-values < 0.05 were considered as significant variables. Results The cohort contributed a total follow-up time of 14,600 child-months, with an overall mortality rate of 3.2 (95% CI: 2.3, 4.3) per 100 child-years. This study also indicated that HIV-infected children presenting with opportunistic infections (OIs) (AHR: 2.5, 95% CI: 1.04, 5.9), anemia (AHR: 3.1, 95% CI: 1.4, 6.7), severe immunodeficiency (AHR: 4.4, 95% CI: 1.7, 11.7), severe stunting (AHR: 3.3, 95% CI: 1.4, 8.0), severe wasting (AHR: 3.1, 95% CI: 1.3, 7.3), and advanced disease staging (III and IV) (AHR: 3.0, 95% CI: 1.2, 7.1) were at higher risk of mortality. Conclusion A higher rate of mortality was observed in our study as compared to previous Ethiopian studies. HIV-positive children presenting with anemia, OIs, severe immunodeficiency, advanced disease staging (III and IV), severe stunting, and severe wasting were at higher risk of mortality.http://link.springer.com/article/10.1186/s12889-020-09418-6Amhara regionEthiopiaARTHIV-positiveMortality |
| spellingShingle | Animut Alebel Eshetu Haileselassie Engeda Mengistu Mekonnen Kelkay Pammla Petrucka Getiye Dejenu Kibret Fasil Wagnew Getnet Asmare Zebenay Workneh Bitew Daniel Bekele Ketema Getnet Gedif Belisty Temesgen Yitbarek Tenaw Hibstie Mamaru Wubale Melkamu Setegn Eshetie Mortality rate among HIV-positive children on ART in Northwest Ethiopia: a historical cohort study BMC Public Health Amhara region Ethiopia ART HIV-positive Mortality |
| title | Mortality rate among HIV-positive children on ART in Northwest Ethiopia: a historical cohort study |
| title_full | Mortality rate among HIV-positive children on ART in Northwest Ethiopia: a historical cohort study |
| title_fullStr | Mortality rate among HIV-positive children on ART in Northwest Ethiopia: a historical cohort study |
| title_full_unstemmed | Mortality rate among HIV-positive children on ART in Northwest Ethiopia: a historical cohort study |
| title_short | Mortality rate among HIV-positive children on ART in Northwest Ethiopia: a historical cohort study |
| title_sort | mortality rate among hiv positive children on art in northwest ethiopia a historical cohort study |
| topic | Amhara region Ethiopia ART HIV-positive Mortality |
| url | http://link.springer.com/article/10.1186/s12889-020-09418-6 |
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