Abstract:
Back ground: Antiretroviral Therapy ART has shown to delay progression to AIDS, improve
survival, and result in a greater and more sustained virologic and immunologic response. In
addition it reduces morbidity and mortality, however, the durability of the effectiveness of
HAART remains to be delineated because various factors influence its effectiveness.
Objective: To investigate the survival status and identify the potential predictors of mortality
after initiation of ART among PLHIV in Jigjiga Karamara hospital, Jigjiga zone, Somali region,
Eastern Ethiopia.
Methods: A retrospective follow up study was conducted. Data was collected from February
2014 to March 2014. Secondary data all clients started ART treatment between January 2009
and December 2013 who fulfill inclusion criteria have been included in this study. Both
descriptive and inferential statistics methods were done. Hazard ratios were computed for
potential covariates after checking the assumption of Cox PH model. All variables significant at
P < 0.25 level in the bivariate analysis were included in the final multivariable model and
independent predictors was identified by making use of AHR, 95%CIs, and p value <0.05 as a
cut-off point for statistical significance. All analyses was made using SPSS version 16.0 for
windows.
Result: Study participants were 822 adult patients who started ART in Kharamara hospital.
They were followed for a median of 22 months. This study demonstrated that simple
laboratory and clinical data, prior to ART initiation, can predict patients increased risk of
mortality. The identified independent significant predictors of survival status after initiation of
ART were being male sex (AHR=2.55, 95%CIs (1.02-2.52)), bedridden functional status
(AHR=3.75, 95%CIs (1.33-10.59)), advanced WHO staging III (AHR=3.48, 95%CIs (1.05-
11.54)) and IV (AHR=4.13, 95%CIs (1.21-14.10)), low CD4 count < 50cells/µl(AHR=7.57,
95%CIs (3.38-16.9)) and <50-99cells/µl (AHR=5.85, 95%CIs (2.57-13.)), lower
BMI<18Kg/m2 (AHR=6.11, 95%CIs (2.06-18.14))and poor ART adherence(AHR=9.59,
95%CIs (5.03-18.20)).
Conclusion & Recommendation: The study cohort had similarly lower mortality rate when
compared to other earlier studies conducted in Ethiopia and other African countries. This
emphasizes the importance of ART in reducing morbidity and mortality among PLHIV.
However, a lot needs to be done regarding patient retention and adherence.
