Abstract:
Abstract
Introduction: Despite the availability of antiretroviral therapy for more than 13 years
mortality, rate among children on antiretroviral therapy in Ethiopia remains high. In
Ethiopia, there is still a scarcity of data in related to mortality rate among Human
Immunodeficiency virus infected children on antiretroviral therapy.
Objective: The study was aimed to assess the incidence and predictors of mortality
among human immunodeficiency virus infected children on antiretroviral therapy in
Amhara regional state referral hospitals, Northwest Ethiopia.
Methods: An institution based retrospective follow up study was conducted among
553 among human immunodeficiency virus infected children on antiretroviral therapy
from January 1, 2012 to February 28, 2017. A simple random sampling technique
was employed to select the study participants. Data were collected from patient
charts by using a data abstraction tool. Data were entered into Epi-data version 3.1
and analysis was done using STATA 13. The Kaplan-Meier survival curve was used
to estimate the survival time. Log rank tests were used to compare the survival
curves between different predictor variables. Bivariable and multivariable Cox
proportional hazard regression models were fitted to identify predictors of mortality.
The results: A total of 538 children records were included in the final analysis. Of
whom, 7.06% were died in the overall follow up time. In this study, the mortality rate
was 3.2 (95% CI: 2.3, 4.3) per 100 child-years. Baseline opportunistic infection
(AHR: 2.5, 95% CI: 1.0, 5.6.0), low hemoglobin level (AHR: 3.1, 95% CI: 1.4, 6.7),
CD4 cell count or percent below the threshold (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 stage (III and IV) (AHR: 95% CI: 3.0 (1.3, 7.1) were found to
be predictors of mortality.
Conclusion: There was a high rate of mortality. Baseline opportunistic infection, low
hemoglobin level, CD4 count or percent below the threshold, severe wasting, severe
stunting and advanced disease stage were predictors of mortality. This highlights the
importance of giving a special emphasis in the first year of antiretroviral therapy.
Keywords: ART, Children, HIV, mortality, Northwest Ethiopia
