Modeling Time to Death of Patients by Multi Drug Resistant Tuberculosis at Saint Peter’s Hospital, Ethiopia

Abstract

World Health Organization (WHO) Annual Global TB Report, Ethiopia ranked 7th in the world for TB burden and 15th from 27 highest MDR-TB burden countries .The Ethiopian Federal Ministry of Health(FMOH) Hospital statistics data has shown that tuberculosis is the leading cause of morbidity, the third cause of hospital admission and the second cause of death in Ethiopia, after malaria. Objective: The objective of this study was to identifying the risk factors for death of MDR-TB at Saint Peter‟s specialized TB Hospital. Methods: A facility based retrospective cohort study was conducted at St.Peter‟s specialized TB Hospital from January 3, 2014 to October 28, 2016. 320 MDR-TB patients included in the study.Classical survival analysis like Cox PH regression model, Stratified Cox regression model and Weibull accelerated failure time model were employed to identify the risk factors MDR-TB patients. Bayesian Weibull accelerate failure time was employed to identify significant effect covariate on the survival time of MDR-TB patients. Results: The median survival time of the patients was about 597 days with maximum and minimum survival time 969days and 1 day respectively. From Accelerated failure time result, the risk factor for the mortality of multidrug resistance tuberculosis patients were Age of patient(ETR=0.918;Cl=0.885,0.952), Body mass index(ETR=1.204;CL=1.028,1.410),smoking status(ETR=.209,CL=0.073,0.594),HIVco-infection(ETR=0.362,CL=0.137,0.953), morbidity(ETR=0.220,CL= 0.062,0.789) and TB status (ETR=7.879,CL=2.519,24.643) at 5% level of significance. From Bayesian result the risk factor for the mortality of multi drug resistance tuberculosis patient were Age of patient( 𝜈=0.012,CRI=(0.001,0.012)),TBstatus(𝜈 = −0.549,CRI=(-1.818,-0.507)),Smoking(𝜈=0.155, CRI =(0.074,0.570)) andComorbidity (𝜈 = 0.055, CRI = (0.011,0.323)) at 95% credible interval. Conclusions: Mortality rate of patients was high at the earlier times of treatment. Demographic and health factors were associated with increased risk of mortality, therefore potential stakeholders like government and non-governmental organizations should pay attention to the subject.