Incidence of death and its predictors among TB/HIV coinfected adult patients receiving anti-retroviral therapy at Gambelia referral hospital, Southwest Ethiopia, 2022

Abstract Background In patients who have tuberculosis and the human immunodeficiency virus, Tuberculosis is the most prevalent opportunistic illness and the main cause of death. However, little is currently, the time to death and its predictors are known, particularly among individuals with coinfect...

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Main Authors: Endeshaw Habtamu Wolelaw, Endalk Getasew Hiruy, Asiya Mohammed Abdu, Kebadnew Mulatu Mihretie
Format: Article
Language:English
Published: BMC 2025-04-01
Series:BMC Infectious Diseases
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Online Access:https://doi.org/10.1186/s12879-025-10878-7
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Summary:Abstract Background In patients who have tuberculosis and the human immunodeficiency virus, Tuberculosis is the most prevalent opportunistic illness and the main cause of death. However, little is currently, the time to death and its predictors are known, particularly among individuals with coinfection in the study area. Therefore, this study was aimed fill this gap in the region. Objective To assess the incidence of death and its predictors among tuberculosis patients and humans immunodeficiency virus coinfected adult patients receiving antiretroviral therapy in Gambella Referral Hospital, Southwest Ethiopia, 2022. Methods This Retrospective cohort study included 320 coinfected adult patients on antiretroviral therapy from June 2017 to June 2022. Data were extracted from the document by using a structured checklist adapted and prepared on the basis of the charts. Death is the event, whereas not having experienced death is censored. The data were entered in to Epi-data version 3.1 and then export to STATA version 14. Kaplan- Meier curve and log rank tests were used to compare the survival curves and estimate survival time. Cox regression model was used to identify significant predictors of death. A Cox-Snell residual plot was used to measure the Cox model goodness of fit. Results The cumulative mortality rate for the 320 coinfected individuals that were monitored was 14.7%, with an incidence rate of 6.7 deaths per 1000 person-months (95% CI: 5.0–8.9). Individuals with low adherence to ART who are female (AHR 2.1, 95%CI: 1.05–4.21). In contrast, non-users of cotrimoxazole treatment (AHR = 4.03, 95%CI: 1.99-. The risk of death was greater for those with a viral load > 1000 copes/ml (AHR: 3.18, 95%CI: 1.19–8.52). Conclusion and recommendation In comparison to Ethiopia's 2021 death rate, the study area's mortality incidence rate was high. There was a higher risk of death for ART-using female patients, those with poor ART adherence, those with an opportunistic infection other than tuberculosis, those with a viral load value between 50 and 1000 copies per milliliter and more than 1000 copies per milliliter, and those who did not use cotrimoxazole prophylactic therapy. Therefore, extensive monitoring and counseling can be beneficial for patients with virus loads greater than 1000 copies/ml, non-CPT users, females, and poor ART adherence.
ISSN:1471-2334