Browsing by Author "Gemechu, Jifare"

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    Survival and predictors of mortality among TB-HIV co-infected children attending anti-retroviral therapy clinics of selected public hospitals in SNNPR, Ethiopia 2020: a retrospective cohort study.
    (Addis Abeba University, 2020-09) Gemechu, Jifare; Gebremichael, Bereket(Ass’t professor); Tesfaye, Tewodros (MSc)
    Background: TB/HIV co-infection poses a great impact to public health. TB is the most common opportunistic infection and the most common cause of mortality in HIV infected children around the globe. But there is scarceness of studies concerning the predictors of mortality among TB-HIV co-infected children. Objective: To assess the survival and predictors of mortality among TB-HIV co-infected children attending ART clinics of public hospitals in SNNPR, Ethiopia from 2009-2019. Methods: Hospital-based retrospective cohort study was employed from January 1 , 2009 to December 31 st 2019 among 284 TB-HIV co-infected children attending ART clinics of selected public hospitals in SNNPR, Ethiopia. Then, medical records were reviewed using a structured data extraction tool. Data were entered using Epidata 4.6 and analyzed using SPSS version 23. The Kaplan Meier survival curve along with log rank tests was used to estimate and compare survival time. Bi variable and multivariable Cox regression were conducted to identify predictors of mortality among TB/HIV co-infected children. Adjusted Hazard Ratio with its 95% confidence interval was used to estimate the strength of association and P-value ≤ 0.05 was considered as statistically significant. Result: A total of 284 TB/HIV co-infected children were included in the study. Among these, 35 (12.3%) of them died during the study period. The overall mortality rate was 2.78 (95%CI= 1.983.99) per 100 child years of observation. The independent predictors of mortality were anemia (AHR=3.6; 95%CI: 1.39-9.31), fair or poor ART drug adherence (AHR=2.9; 95%CI=1.15-7.43), extra pulmonary TB (AHR=3.9; 95%CI: 1.34-11.45) and TB drug resistance (AHR=5.7; 95%CI: 2.07-15.96). Conclusion: Mortality rate of TB/HIV co-infected children in selected public hospitals in SNNPR, Ethiopia was high. Moreover, anemia, drug resistant tuberculosis, extra pulmonary TB and poor adherence to ART drugs were identified as the predictors of mortality among these children. st