Predictors of mortality and health related quality of life in patients receiving ART, Adama hospital, Oromia region
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Date
2010-06
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Addis Abeba Universty
Abstract
Background: HIV/AIDS is one of the pandemic diseases affecting many people in the world.
In the year 2008 it is estimated that 33.4 million [31.1million-35.8 million] people were
living with HIV/AIDS worldwide. The human immune-deficiency virus (HIV) has created an
enormous challenge worldwide. Since 1996, the advent of new classes of ARV drugs and
their use in combination prolonged many lives, improved quality of life, revitalized
communities and transformed perceptions of HIV/AIDS from a plague to a manageable
chronic illness. Though there are few researches done in Africa including Ethiopia, a
significantly high mortality of patients on ART is registered than mortality of patients on
ART in developed countries. In Ethiopia, 179,183 clients have accessed ART till February
2010. The issue of mortality and quality of life in patients on ART is not yet well documented
based on previous studies in Africa in general and in Ethiopia in particular except a few
study.
OBJECTIVE:
To assess Predictors of mortality and health related quality of in HIV/AIDS patients receiving
ART in Adama hospital, Oromia region
Methodology:
Hospital based retrospective analytical study was done in Adama hospital, west shoa zone,
Oromia region from October 2009 to June 2010. Quantitative data collection method was
employed to collect data from clinical records of patients with special focus on CD4 count,
Hg, BMI and WHO staging of the progression of HIV. A total of 255 subjects selected
systematically were enrolled for the retrospective assessment. In addition to this, 258 subjects
selected randomly who were on ART treatment were also interviewed for Health related
quality of life. Data entry, data cleaning was done by EPI INFO2002 version 3.5.1 which was
transported to SPSS version 15 and analysed.
Result: In Adama hospital 14,620 patients were ever enrolled for HIV/AIDS care, 8,442
patients ever started ART and 5930 patients are currently on ART. Data of 255 patients on
ART (128 male and 127 females) was taken from clinical charts and ART data base. The age
ranged from 18-64 with mean age of 34.6 years. All of them started ART from September to
August 2005.Of the 255 patients, 167 were from Adama town and 88 were from other places.
Mortality rate within five years of retrospective follow up was 41(16.1%). The finding
showed WHO stage IV [HR 3.28 95% CI1.65-6.53, p=0.001] and CD4<50/μl [HR 2.07 95%
CI 1.05-4.07, p=0.004] were significant predictors of mortality. Similarly drug regimen 1b,
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age group greater than 45, bed ridden functional status were also found significant predictors
of mortality. Health related quality of life was assessed for 255 patients on ART from Adama
hospital. The result showed score of 23.9 for general health and 83.4 for physical function
implying that they are with good physical function but with poor health perception.
Conclusion: The overall mortality rate in this finding is similar to most of studies done in
Africa as well as in Ethiopia. Low CD4, WHO stage IV are common predictors in most
studies. However in this study, in addition, bed ridden functional status, age group greater
than 45 and drug regimen 1b were also significant predictors of mortality. Health related
quality of life score is from moderate to high in most of health related quality of life
(HRQOL) items and it is similar to other studies.
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Keywords
Predictors of mortality