Survival and Its Determinant of Multidrug-Resistant Tuberculosis Patients with (HIV) Co-Infection: St. Peter Tuberculosis Specialized Hospital Addis Ababa, Ethiopia
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Date
2016-12
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Addis Ababa University
Abstract
Back ground
According to World Health Organization (WHO) 2015 report globally 480 000 new cases and 190,000 estimated deaths occurred in 2014 due to MDR TB. Ethiopia ranked 7th from top 22 highest TB-burden and 15th from 27 highest MDR-TB burden countries; and one of high HIV/AIDS prevalent in Sub-Sahara African countries. Nevertheless, a little known about Survival of Multidrug-resistant Tuberculosis patients with HIV/AIDS co-infection in Ethiopia. Hence, this study is to determine the Survival and their determinants in MDR TB patients co-infected with HIV/AIDS Addis Ababa, Ethiopia
Method
A retrospective cohort study design was conduct at St. Peter TB specialized hospital Addis Ababa, Ethiopia; from February to March 2016. Survival of exposed and non-exposed groups was compared by Kaplan-Meier survival functions by using log-rank test. Factors that associated with outcome variables at 20 % (p<0.2) significant level in the bivariate analysis was included in the final Multivariable analysis. Cox proportional hazards regression model was used to determine factors associated with risk of death by controlling confounding and effect modifier.
Result
Out of 93 expose groups 48 (51.61%) were female and the rest 45 (48.39%) were male. Ninety three exposed study subjects were survive for a total of 26,581 person per 10000 days, and 213 non-exposed study subjects were survive for a total of 63,782 person per 10000 days. Median survival time of exposed study subjects was 269 person days and for non-exposed study subjects had 254 person days median survival time. Kaplan Meier survival curve shows lower survival (long-rank test, P<0.010) was seen in exposed groups compared to non-exposed group throughout the follow up time with parallel survival estimate curve. Independently associated factors for increasing risk of death was hospitalization at the time of treatment initiation (HR: 8.64; [1.11 - 67.00]), presence of HIV co-infection (HR: 2.15; [1.04 - 4.46] and age greater than or equal to 65 (HR: 10.07; [1.80 - 56.29].
Conclusion
This study find out MDR TB patients without HIV had better survival than those MDR TB patients with HIV co-infection. Hospitalization at the time of treatment initiation, presence of HIV co-infection and age greater than or equal to 65 years of age increase the risk of death.
Recommendations
Early detection (diagnosis) and treatment for MDR TB for HIV positive patients; regular medical check-up for MDR TB to aged people; decrease hospitalization by early diagnosis and treatment and further studies on MDR TB and survival of older population
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Keywords
Multidrug-Resistant Tuberculosis Patients