Pattern in Consumption of Antiretroviral Drugs in Art Pharmacy Ethiopia Retrospective Study

• Enquiry
• Open Access
• Published: 18 May 2012

Predictors of bloodshed among HIV infected patients taking antiretroviral treatment in Ethiopia: a retrospective cohort study

AIDS Research and Therapy volume 9, Article number:15 (2012) Cite this article

• 8712 Accesses

• 45 Citations

• 1 Altmetric

• Metrics details

Abstract

Background

Studies indicate that there is high early mortality among patients starting antiretroviral treatment in sub-Saharan Africa. However, there is paucity of evidence on long term survival of patients on anti-retroviral treatment in the region. The objective of this study is to examine mortality and its predictors amidst a cohort of HIV infected patients on anti-retroviral treatment retrospectively followed for five years.

Methods

A retrospective accomplice study was conducted among HIV infected patients on Art in eastern Ethiopia. Cox regression and Kaplan-Meier analyses were performed to investigate factors that influence fourth dimension to decease and survival over fourth dimension.

Consequence

A full of 1540 written report participants were included in the study. From the registered patients in the cohort, the issue of patients as agile, deceased, lost to follow upward and transfer out was 1005 (67.2%), 86 (5.ix%), 210 (14.0%) and 192 (12.viii%) respectively. The overall mortality rate provides an incidence density of 2.03 deaths per 100 person years (95% CI i.64 - 2.fifty). Out of a total of 86 deaths over threescore month period; 63 (73.three%) died during the first 12 months, 10 (11.vi%) during the second twelvemonth, and x (11.half dozen%) in the third yr of follow upwards. In multivariate analysis, the independent predictors for bloodshed were loss of more 10% weight loss, bedridden functional status at baseline, ≤ 200 CD4 cell count/ml, and avant-garde WHO stage patients.

Conclusion

A lower level of mortality was detected among the accomplice of patients on antiretroviral treatment in eastern Ethiopia. Previous history of weight loss, crippled functional condition at baseline, low CD4 cell count and advanced WHO status patients had a higher risk of expiry. Early initiation of ART, provision of nutritional support and strengthening of the food by prescription initiative, and counseling of patients for early on presentation to handling is recommended.

Introduction

Development of highly active antiretroviral treatment (ART) in the mid-1990s revolutionized the care of HIV-infected patients and led to marked reductions in HIV-associated morbidity and mortality in many industrialized countries [1, 2]. Fine art has clearly shown to exist effective in reducing mortality amidst those who remain in treatment and adhere to therapy [2–4]. In recent years in developing countries with a high burden of AIDS, Fine art has get more than widely available. According to estimation past the Earth Health Organisation (WHO), virtually 6 650 000 patients were receiving Fine art in low- and middle-income countries past the end of 2010 [v], this is a huge comeback from the levels in 2003 [six, 7]. 2 sub-Saharan African countries, Republic of botswana and Rwanda, have achieved universal access target (treatment coverage of 80% or more than of patients in demand) at the stop of 2009 [7], while countries such equally Ethiopia, Republic of zambia, Namibia and Senegal are moving closer to the same target having covered 50-fourscore% of patients in need of handling [seven]. Due to this morbidity and mortality among HIV-infected persons have dramatically decreased [8, 9].

The master goals of antiretroviral therapy are preventing HIV-related morbidity and mortality, and improving quality of life by restoring immunologic function through suppression of viral load [x]. Many studies accept reported high early mortality among patients starting antiretroviral handling in sub-Saharan Africa [4]. One of the reasons cited for this is that despite better availability of ART, people are yet diagnosed late and thus first ART at later stages of the HIV disease [11].

In Ethiopia, there were more than 222,000 patients on antiretroviral treatment at the finish of 2010 [6]. Art has improved survival of patients with HIV/AIDS and improved the quality of life of patients in the country [12]. In Ethiopia, in that location are no studies reporting the long term survival of patients on antiretroviral treatment. Such studies could provide valuable information to evaluate the Art programme in the land. The objective of this study is to examine bloodshed and its predictors among a cohort of HIV infected patients on antiretroviral treatment retrospectively followed for five years.

Methods

Report area and menses

The study was conducted in Hiwot Fana, Jugal and Dil Chora hospitals located in eastern Federal democratic republic of ethiopia. Data was collected from September to November 2010.

Study blueprint

A retrospective cohort study was conducted amid HIV patients on Art. A random sample of 1537 patients that started treatment between September 11, 2005 and September ten, 2008 were included in the written report and retrospectively followed up for an additional two years until September 10, 2010. The patients' identification numbers were used to generate the necessary sample from the records of the hospitals for extracting data.

Socio-demographic characteristics, baseline and follow up clinical and laboratory measurement information, and treatment outcomes were abstracted from patients' cards. The principal result measure was patient survival, while secondary event measures included CD4 count and body weight.

Data collection and quality control

A standard questionnaire was used for recording data extracted from patients' cards. This form is developed using the standardized Art entry and follow up grade employed by the ART clinic. The CD4 count laboratory results recorded before starting Fine art were used as a base of operations line values. If there is no pre-treatment laboratory test, nonetheless, results obtained within ane month of ART initiation were considered as baseline values. Four experienced Fine art nurses who were trained on comprehensive HIV care and involved in patient follow ups collected the data. Data collection was supervised by the researchers. All completed information drove forms were examined for clarity and consistency. The data were entered and cleaned by trained data clerks and the investigators before analysis.

Death was ascertained by reviewing cards and death certificates. Patients who died from unrelated diseases or accident were considered every bit censored, as well every bit those alive at the end of the follow upwards period.

Data assay

Descriptive statistics such as median, hateful, SDs and tables were be used to investigate the characteristics of the cohort. Person years of follow upwards were calculated by assessing the date of enrollment for ART and death or censoring. Survival assay and the Kaplan-Meier test were used to investigate factors that influence time to decease. Hazard ratios (HR), equally well equally 95% confidence intervals were used as effect measures. A p-value of 0.05 was used. Descriptive statistics and Cox regression were conducted using SPSS® version sixteen. Proportionality of hazards test on Schoenfeld residuals and graph were conducted using STATA® version ten.

Ethical consideration

Upstanding clearance was obtained from the Institutional Research Ethics Review Committee (IRERC) of Haramaya University. All information collected from patients cards were kept strictly confidential and names were non included in the abstracted data.

Results

Characteristics of patients

A total of 1540 study participants were included in the study. The sample comprised 963 (62.5%) females and 574 (37.3%) males respectively. The median and inter-quartile range (IQR) age was 32 and 28–40. The majority of participants 1074 (69.9%) were Orthodox Christians and 305 (19.viii) were Muslim. Clinically, 890 (58.2%) and 348 (22.seven%) patients were on the stage Iii and II. The median (IQR) baseline CD4 count was 135 (76.0–198.3) per milliliter (Table 1).

Table 1 Baseline characteristics of HIV infected patients initiating antiretroviral therapy

Full size table

Follow upward and survival patterns of the cohort

From the registered patients in this cohort analysis, the outcome of patients as active, deceased, lost to follow up and transfer out were 1005 (67.two%), 86 (5.9%), 210 (xiv.0%) and 192 (12.8%) respectively. There were 86 deaths in 4234.eight person years of retrospective follow up Figure one displays the survival patterns of the accomplice based on WHO clinical stage categories. The overall bloodshed charge per unit provides an incidence density of 2.03 deaths per 100 person years (95% CI 1.64–2.50). Out of a full of 86 deaths over 60 month period; 63 (73.3%) died during the first 12 months, 10 (11.6%) during the second year, and x (11.6%) in the tertiary year of follow up. When the follow-up menses was divided into 1-year time bands (from ART initiation through 1 year, from 1 year through 2 years, and from 2 years though 3 years), the mortality rates per 100 person years at risk were 55.67 (95% CI 43.48–71.26), iv.03 (95% CI 2.17–7.51), and 0.31 (95% CI 0.18–0.54) respectively.

Effigy i

Survival functions stratified co-ordinate to WHO clinical staging in HIV infected patients in a accomplice of patients on antiretroviral handling in eastern Ethiopia (y-axis truncated to improve visibility).

Total size image

Predictors of bloodshed

In univarite analysis, factors associated with the predictor of mortality were previous weight loss of more than 10%, bedridden functional status at baseline, less than 200 CD4 cells/ml and WHO stage Iv patients. Those patients who reported to have lost a weight of more than 10% at baseline were 5 times more probable to die compared to those who did not (adventure ratio, 60 minutes 4.41; 95% CI 1.08–17.92). Those patients who were bedridden or not-convalescent at the initiation of treatment were v times more likely to die compared with those that were working (Hour five.33; 95% CI three.05–9.30). Those patients whose CD4 prison cell count lied between 201–300 were 58% less likely to die every bit compared to those patients whose CD4 count was less than 200 cells per milliliter (Hr 0.42; 95% CI 0.19–0.92).

In the multivariate analysis, five baseline factors were contained predictors of mortality. WHO stage Iv patients were three times more than likely to dice compared to stage I and Ii patients (HR three.19; 95% CI 1.51–half-dozen.76). Bedridden patients were 4 times more than likely to die compared with those patients who are working (HR 4.09; 95% CI ii.12–7.90). Patients who reported to have lost more than x% of their weight at baseline were 5 times more likely to die compared to those patients who did non (Hr 4.93; 95% CI one.20–twenty.41). Patients whose CD4 cell counts between 201–300 were 60% less likely to die compared to those whose CD4 counts less than 200 (HR 0.40; 95% CI 0.17–0.93). Those patients with primary education were nearly 3 times more likely to die than illiterate counterpart (HR 2.79; 95% CI 1.26–6.16) (Table 2).

Table 2 Predictors of mortality amidst a sample of HIV infected cohorts on anti-retroviral treatment in eastern Federal democratic republic of ethiopia

Full size table

Discussions

The findings indicate that from the registered cohort, there were 86 deaths in 4234.8 years of retrospective follow up, providing an incidence density of two.03 deaths per 100 person years (95% CI 1.64–2.51). Nigh 210 (14.0%) patients were lost to follow upwardly. Factors that were associated with bloodshed were 10% weight loss, bedridden functional status at baseline, ≤200 CD4 cells/ml and advanced stage patients.

Long-term retentiveness of patients in antiretroviral treatment is a prerequisite for achieving any adherence at all. Diverse studies have shown that mortality during the first half-dozen months after initiating Art is much college than in developed countries and retention of patients in programs is poor [4, 13]. However, nigh longitudinal studies conducted in Africa have been either brusk-term or have involved small-scale numbers of participants.

In our study, the overall mortality rate of 2.03 deaths per 100 person years is lower or comparable to that reported elsewhere; however the mortality rate at the first year (55.67; 95% CI 43.5–71.3; or four.3%) is loftier. In the ART-LINC Collaboration, which analyzed data from 18 cohorts across the developing world, mortality averaged 4.2% across all xviii cohorts in the commencement yr subsequently initiation [11]. In Yaounde, Republic of cameroon, from 312 patients, the incidence rate of mortality charge per unit was 21.2 per 100 person years (95% CI xv–31) [14]. In southern Ethiopia, the bloodshed rate was 15.4 per 100 person-years of observation [12]. The majority or 74.one% of the deaths occurred in the first year after treatment. The report highlights the loftier early on mortality in Art cohorts in resource-limited settings that has been observed past other groups in like settings [4, xv, 16].

The main causes of expiry in AIDS patients could be the causes such immune reconstitution syndrome and opportunistic infections as a outcome of very weak immunity levels. In our study ane of the factors associated with early mortality is late presentation for Fine art. This may also account for the high charge per unit of death in the first year. Co-ordinate to reports, patients that outset ART at WHO Phase Three and 4 are at an increased risk of dying [17, eighteen]. Furthermore, early bloodshed risk is higher among those with low CD4 cell count [4, xix]. The CD4 count is a proxy indicator of severity of disease which corresponds to the functional status and reflects the immune state of patients [twenty]. In our study, the functional status of patients at the entry level had a positive correlation with their affliction stage and negative correlation with CD4 count. In a report from Hong Kong, in that location was a 79% reduction in mortality among Art taking patients with CD4 counts of less than 200/ml [21]. The majority of morbidity and mortality seen among individuals starting Fine art with depression baseline CD4 prison cell count occurs during the beginning three–6 months on handling [2, 3, 15, 16, 22]. In 1 written report patients initiating Art with a base of operations-line CD4 prison cell count of less than 50 cells/mm3 had a iii.two-fold higher bloodshed rate (p 0.004) compared with patients with a CD4 cell count betwixt 51 and 200 cells/mm3 at the time of ART initiation [23]. Patients starting treatment with CD4 cell count below 100 cells/mm3 were at significantly greater risk of death during the follow-up menses (OR two.69; 95% CI ane.12–6.44) [12].

Nutritional and physical condition can predict early bloodshed. In our written report, 10% weight loss determines bloodshed during the course of treatment. In a commune infirmary in Ethiopia, weight loss was seen in nearly a third of patients who survived up to the fourth week, and it was associated with increased death [18]. College body weight at baseline was constitute to exist associated with lower risk of mortality with a Hour of 0.58 for weight groups of twoscore–50 kilograms compared with the reference of less than 40 kilograms, and HR of 0.25 for groups ≥sixty kilograms compared with the reference groups (p < 0.013). The two year patient survival was significantly related with co-trimoxazole initiation at or before treatment, clinical stage IV disease, working functional status and weight greater than lx kilograms [24]. In another study, baseline body mass alphabetize (BMI) of less than 18.5 was independently associated with early mortality risk [nineteen].

Virtually 61% of patients in this study had education below secondary schoolhouse. According to reports, depression educational level amid patients is a contributing factor to belatedly presentation for Art [25]. This is understandable since the more than educated a patient is the better their agreement of the disease country and comprehension of instructions given on drug usage. These could raise treatment outcomes [26]. A written report from British Columbia reported a protective event of educational level on mortality from all causes among intravenous drug users receiving anti-retroviral handling [27, 28]. Almost reports suggest that depression educational level has consistently been associated with higher bloodshed, both overall and cause-specific [29, thirty]. In our study lower educational level was associated with a college take chances of mortality. However, patients with principal educational activity seem to exist at college chance of death compared to those with no didactics. This is an interesting finding for which nosotros could non find caption due to the nature of our data, however it needs farther investigation in time to come research.

This study has limitations. CD4 cell counts and HIV RNA measurements were non available for all patients considering of cost issues. Diagnostic tests that would ostend the presence of certain opportunistic infections were limited; as a result nosotros were not able to include these in our analysis. The retrospective accomplice study design express our ability to gather data most factors that may influence the take a chance of mortality, for instance factors such as lack of social supports networks, disclosure of infection status and depression. Data was collected from those who were attending ART centers mostly through cocky-reporting and hence may accept reporting and recall bias. In Fine art programs of developing countries similar Ethiopia, poor ascertainment of deaths and recording of data on losses to follow upwardly may lead to underestimation of bloodshed rates.

In decision, nosotros detected a relatively lower level of mortality among the cohort of patients on antiretroviral handling in eastern Ethiopia. Previous history of weight loss, bedridden functional status at baseline, depression CD4 cell count and avant-garde WHO patients had a college risk of death among the retrospective accomplice. So early initiation of ART while CD4 counts are higher and opportunistic infections express, provision of nutritional support and strengthening the food by prescription initiative, and counseling of patients for early on presentation during testing for HIV is recommended.

References

1. Palella FJ, Deloria-Knoll Thou, Chmiel JS, Moorman AS, Wood KC, Greenberg AE, Holmberg SD, HIV Outpatient Study (HOPS) Investigators: Survival benefit of initiating antiretroviral therapy in HIV-infected persons in different CD4+ cell Strata. Ann Intern Med. 2003, 138: 620-626.

   Article  PubMed  Google Scholar

2. Egger M, May M, Chêne Thou, Phillips AN, Ledergerber B, Dabis F, Costagliola D, D'Arminio Monforte A, de Wolf F, Reiss P: Prognosis of HIV-1-infected patients starting highly active antiretroviral therapy: a collaborative analysis of prospective studies. Lancet. 2002, 360: 119-129. 10.1016/S0140-6736(02)09411-4

   Article  PubMed  Google Scholar

3. Coetzee D, Hildebrand One thousand, Boulle A, Maartens G, Louis F, Labatala V, Reuter H, Ntwana North, Goemaere E: Outcomes later on two years of providing antiretroviral treatment in Khayelitsha, South Africa. AIDS. 2004, 18: 887-895. 10.1097/00002030-200404090-00006

   Article  PubMed  Google Scholar

4. Lawn SD, Harries Advertizement, Anglaret Ten, Myer L, Wood R: Early mortality amid adults accessing antiretroviral treatment programmes in sub-Saharan Africa. AIDS. 2008, 22: 1897-1908. 10.1097/QAD.0b013e32830007cd

   Article  PubMed  Google Scholar

5. UNAIDS: Global study: UNAIDS report on the global AIDS epidemic 2010. vol. x.11E | JC1958E. 2010, Joint United nations Plan on HIV/AIDS (UNAIDS), Geneva

   Google Scholar

6. UNAIDS, WHO, UNICEF: Global HIV/AIDS response - Epidemic update and health sector progress toward univeral access - Progress report 2011. 2011, UNAIDS, Geneva

   Google Scholar

7. WHO: Towards universal admission - Scaling upward priority HIV/AIDS interventions in the health sector - Progress written report 2010. 2010, Earth Health Organization, Geneva

   Google Scholar

8. Centers for Affliction Command and Prevention (CDC): HIV/AIDS Surveillance Report. 2001, (US Department of Wellness and Human Services ed, Atlanta

   Google Scholar

9. Mocroft A, Vella Due south, Benfield TL, Chiesi A, Miller V, Gargalianos P, D'Arminio Monforte A, Yust I, Bruun JN, Phillips AN, Lundgren JD: Irresolute patterns of bloodshed across Europe in patients infected with HIV-1. EuroSIDA Study Grouping. Lancet. 1998, 352: 1725-1730. 10.1016/S0140-6736(98)03201-2

   CAS  Commodity  PubMed  Google Scholar

10. Hoffmann C, JK R, Kamps S, : HIV Medicine 2007. 2007, Flying Publishers, Paris

    Google Scholar

11. Braitstein P, Brinkhof MW, Dabis F, Schechter M, Boulle A, Miotti P, Forest R, Laurent C, Sprinz East, Seyler C: Mortality of HIV-1-infected patients in the commencement twelvemonth of antiretroviral therapy: comparison betwixt low-income and high-income countries. Lancet. 2006, 367: 817-824.

    Commodity  PubMed  Google Scholar

12. Jerene D, Naess A, Lindtjørn B: Antiretroviral therapy at a district hospital in Ethiopia prevents death and tuberculosis in a cohort of HIV patients. AIDS Res Ther. 2006, iii: 10- 10.1186/1742-6405-3-10

    PubMed Central  Article  PubMed  Google Scholar

13. Jaffar S, Munderi P, Grosskurth H: Adherence to antiretroviral therapy in Africa: how high is it really?. Tropical Medicine and International. 2008, thirteen: 1096-1097. 10.1111/j.1365-3156.2008.02131.x.

    Article  Google Scholar

14. Rougemont M, Stoll Exist, Elia N, Ngang P: Antiretroviral handling adherence and its determinants in Sub-Saharan Africa: a prospective report at Yaounde Central Infirmary. Republic of cameroon. AIDS Research and Therapy. 2009, 6: 21-

    Article  PubMed  Google Scholar

15. Stringer JS, Zulu I, Levy J, Stringer EM, Mwango A, Chi BH, Mtonga Five, Reid S, Cantrell RA, Bulterys Grand: Rapid calibration-upwards of antiretroviral therapy at main care sites in Zambia: feasibility and early outcomes. JAMA. 2006, 296: 782-793. 10.1001/jama.296.seven.782

    CAS  Commodity  PubMed  Google Scholar

16. Weidle PJ, Malamba S, Mwebaze R, Sozi C, Rukundo Yard, Downing R, Hanson D, Ochola D, Mugyenyi P, Mermin J: Assessment of a airplane pilot antiretroviral drug therapy plan in Uganda: patients' response, survival, and drug resistance. Lancet. 2002, 360: 34-40. x.1016/S0140-6736(02)09330-3

    CAS  Article  PubMed  Google Scholar

17. Amuron B, Levin J, Birunghi J, Namara G, Coutinho A, Grosskurth H, Jaffar S: Mortality in an antiretroviral therapy plan in Jinja, southward-eastward Uganda: a prospective cohort study. AIDS Res Ther. 2011, 8: 39- x.1186/1742-6405-8-39

    PubMed Central  Commodity  PubMed  Google Scholar

18. Jerene D, Endale A, Hailu Y, Lindtjørn B: Predictors of early on death in a cohort of Ethiopian patients treated with HAART. BMC Infect Dis. 2006, 6: 136- 10.1186/1471-2334-6-136

    PubMed Primal  Article  PubMed  Google Scholar

19. Backyard SD, Picayune F, Bekker LG, Kaplan R, Campbel Due east, Orrell C, Forest R: Changing bloodshed gamble associated with CD4 cell response to antiretroviral therapy in South Africa. AIDS. 2009, 23: 335-342. ten.1097/QAD.0b013e328321823f

    PubMed Primal  Commodity  PubMed  Google Scholar

20. May M, Sterne JA, Sabin C, Costagliola D, Justice Ac, Thiébaut R, Gill J, Phillips A, Reiss P, Hogg R: Prognosis of HIV-1-infected patients upwards to five years afterward initiation of HAART: collaborative assay of prospective studies. Lancet. 2007, 21: 1185-1197.

    Google Scholar

21. Chan CW, Cheng LS, Chan WK, Wong KH: Highly active antiretroviral therapy per se decreased bloodshed and morbidity of advanced human immunodeficiency virus disease in Hong Kong. Chin Med J. 2005, 118: 1338-1345.

    CAS  PubMed  Google Scholar

22. Duncombe C, Kerr SJ, Ruxrungtham 1000, Dore GJ, Law MG, Emery South, Lange JM, Phanuphak P, Cooper DA: HIV affliction progression in a patient cohort treated via a clinical research network in a resource limited setting. AIDS. 2005, 19: 169-178. ten.1097/00002030-200501280-00009

    Article  PubMed  Google Scholar

23. Wester CW, Kim South, Bussmann H, Avalos A, Ndwapi N, Peter TF, Gaolathe T, Mujugira A, Busang 50, Vanderwarker C: Initial response to highly agile antiretroviral therapy in HIV-1 C-infected adults in a public sector treatment program in Botswana. J Acquir Immune Defic Syndr. 2005, 40: 336-343. 10.1097/01.qai.0000159668.80207.5b

    Commodity  PubMed  Google Scholar

24. Worku A: Blueprint and determinants of survival in adult HIV patients on antiretroviral therapy, Ethiopia. Umeå university, Umeå International Schoolhouse of Public Health, Department of Epidemiology and Public Health sciences. 2009

    Google Scholar

25. Bello SI: Direction Outcomes of HIV/aids Patients on Haart in a Secondary Health Establishment in North Central, Nigeria. Pharmacologia. 2012, 3: 336-343.

    Article  Google Scholar

26. Bello SI, Itiola OA: Drug adherence amongst tuberculosis patients in the University of Ilorin Pedagogy Infirmary, Ilorin, Nigeria. African Journal of Chemist's shop and Pharmacology. 2010, 4: 109-114.

    Google Scholar

27. Jarrin ILB, Ferreros I: Effect of education on overall and causespecific mortality in injecting drug users, co-ordinate to HIV and introduction of HAART. Int J Epidemiol. 2007, 36: e187-e194.

    Article  Google Scholar

28. Wood EMJ, Chan Thou: Socioeconomic status, access to triple therapy, and survival from HIV-illness since 1996. AIDS. 2002, 16: e2065-e2072. 10.1097/00002030-200210180-00012.

    Article  Google Scholar

29. Jarrin I, Lumbreras B, Ferreros I, Pérez-Hoyos S, Hurtado I, Hernández-Aguado I: Upshot of education on overall and crusade-specific mortality in injecting drug users, according to HIV and introduction of HAART. Int J Epidemiol. 2007, 36: 187-194.

    CAS  Article  PubMed  Google Scholar

30. Wood E, Montaner JS, Chan K, Tyndall MW, Schechter MT, Bangsberg D, O'Shaughnessy MV, Hogg RS: Socioeconomic status, access to triple therapy, and survival from HIV-disease since 1996. AIDS. 2002, xvi: 2065-2072. 10.1097/00002030-200210180-00012

    Article  PubMed  Google Scholar

Download references

Acknowledgements

Nosotros would similar to thank Haramaya University for funding this projection. We likewise acknowledge the cooperation of the Enquiry and Publication Office of Harar Campus, and the office of the Dean of Harar College of Health Sciences. We thank Yordanos Asalif for her secretarial assistance and for helping in the download and press of scientific manufactures. We also give thanks all the health facilities staff for their cooperation and the patients involved in this study.

Author information

Affiliations

1. Department of Epidemiology and Biostatistics, College of Medical and Wellness Science, Jimma University, Jimma, Ethiopia

   Sibhatu Biadgilign

2. Department of Public Health, Higher of Health Sciences, Haramaya University, P. O. Box 235, Harar, Ethiopia

   Ayalu A Reda

3. Department of Medical Laboratory Science, Higher of Health Sciences, Harar, Federal democratic republic of ethiopia

   Tesfaye Digaffe

Corresponding writer

Correspondence to Ayalu A Reda.

Additional data

Competing interests

All authors declare that they accept no competing interest associated with the publication of this manuscript.

Authors' contributions

AAR and SB contributed significantly in the design, manuscript writing and review. AAR conceived and designed the study, nerveless data in the field, performed the data analysis, interpreted the data, and drafted the manuscript and critically reviewed it. TD was significantly involved in information collection and has reviewed the manuscript. All authors approved and read the final manuscript.

Authors' original submitted files for images

Rights and permissions

Open Access This article is published under license to BioMed Primal Ltd. This is an Open Access article is distributed nether the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/past/2.0 ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original piece of work is properly cited.

Reprints and Permissions

About this commodity

Cite this article

Biadgilign, S., Reda, A.A. & Digaffe, T. Predictors of mortality among HIV infected patients taking antiretroviral treatment in Ethiopia: a retrospective cohort study. AIDS Res Ther 9, 15 (2012). https://doi.org/ten.1186/1742-6405-9-15

Download citation

• Received: 02 March 2012

• Accepted: xviii May 2012

• Published: 18 May 2012

• DOI : https://doi.org/x.1186/1742-6405-ix-15

Keywords

• Incidence Density
• High Early Mortality
• Previous Weight Loss
• Early on Bloodshed Run a risk
• Institutional Enquiry Ethic Review Committee

gatenbybegamseley.blogspot.com

Source: https://aidsrestherapy.biomedcentral.com/articles/10.1186/1742-6405-9-15

Share this post