Incidence of advanced opportunistic infection and its predictors among HIV infected children at Debre Tabor referral Hospital and University of Gondar Compressive specialized hospitals, Northwest Ethiopia, 2020: A multicenter retrospective follow-up study

Abstract Background : In resource limited settings, Tuberculosis (TB) is a major cause of morbidity and mortality among patients on antiretroviral treatment. Ethiopia is one of the 30 high TB burden countries. TB causes burden in healthcare system and challenge the effectiveness of HIV care. This study was to assess incidence and predictors of Tuberculosis among adults on antiretroviral therapy at Debre Markos Referral Hospital, Northwest Ethiopia, 2019. Methods : Institution based retrospective follow up study was conducted among adults on ART newly enrolled from 2014 to 2018 at Debre Markos Referral Hospital. Simple random sampling technique was used to select patients chart. Data was entered to EPI- INFO version 7.2.2.6 and analyzed using Stata 14.0. Tuberculosis incidence rate was computed and described using frequency tables. Both bivariable and multivariable Cox proportional hazard models was fitted to identify predictors of TB. Results : Out of the 536 patients chart reviewed, 494 patient records were included in the analysis. A total of 62 patients developed new TB cases during the follow up period of 1000.22 Person Years (PY); which gives an overall incidence rate of 6.19 cases per 100 PY (95% CI: 4.83 - 7.95). The highest rate was seen within the first year of follow up. After adjustment base line Hemoglobin < 10 g/dl (AHR= 5.25; 95% CI: 2.52 - 10.95), ambulatory/bedridden patients at enrolment (AHR = 2.31; 95% CI: 1.13 - 4.73), having fair or poor ART adherence (AHR = 3.22; 95% CI: 1.64 – 6.31) were associated with increased risk of tuberculosis whereas taking Isoniazid Preventive Therapy (IPT) (AHR = 0.33; 95% CI: 0.12 - 0.85) were protective factors of TB occurrence. Conclusion : TB incidence was high among adults on ART especially in the first year of enrollment to ART. Low hemoglobin level, ambulatory or bedridden functional status, non-adherence to ART and IPT usage status were found to be independent predictors. Hence, continuous follow up for ART adherence and provision of IPT has a great importance to reduce the risk of TB.

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Nearly one in every six HIV-infected children lost from ART follow-up at Debre Markos Referral Hospital, Northwest Ethiopia: A 14-year retrospective follow-up study

PLoS ONE ◽

10.1371/journal.pone.0239013 ◽

2020 ◽

Vol 15 (9) ◽

pp. e0239013

Author(s):

Yitbarek Tenaw Hibstie ◽

Getiye Dejenu Kibret ◽

Asmare Talie ◽

Belisty Temesgen ◽

Mamaru Wubale Melkamu ◽

...

Keyword(s):

Northwest Ethiopia ◽

Referral Hospital ◽

Follow Up Study ◽

Debre Markos

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Incidence and predictors of tuberculosis occurrence among adults on antiretroviral therapy at Debre Markos referral hospital, Northwest Ethiopia: retrospective follow-up study

BMC Infectious Diseases ◽

10.1186/s12879-020-04959-y ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Agazhe Aemro ◽

Abebaw Jember ◽

Degefaye Zelalem Anlay

Keyword(s):

Antiretroviral Therapy ◽

Northwest Ethiopia ◽

Referral Hospital ◽

Follow Up Study ◽

Debre Markos

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Incidence and Predictors of Tuberculosis Occurrence among Adults on Antiretroviral Therapy at Debre Markos Referral Hospital, Northwest Ethiopia: Retrospective Follow-up Study

10.21203/rs.2.12735/v1 ◽

2019 ◽

Author(s):

Agazhe Aemro ◽

Abebaw Jember ◽

Degefaye Zelalem Anlay

Keyword(s):

Antiretroviral Therapy ◽

Hiv Infection ◽

Incidence Rate ◽

Northwest Ethiopia ◽

Referral Hospital ◽

First Year ◽

Art Adherence ◽

Follow Up Study ◽

Debre Markos

Abstract Abstract Background: In resource limited settings, Tuberculosis (TB) is the major cause of morbidity and mortality among patients on antiretroviral treatment. Ethiopia is one of the 30 high TB burden countries and it causes burden in healthcare system and challenge the effectiveness of HIV care. This study was to assess incidence and predictors of Tuberculosis among adults on antiretroviral therapy at Debre Markos Referral Hospital, Northwest Ethiopia, 2019. Methods: Institution based retrospective follow up study was conducted among adults on ART newly enrolled from 2014 to 2018 at Debre Markos Referral Hospital. Simple random sampling technique was used to select charts. Data was entered to EPI- INFO version 7.2.2.6 and analyzed using Stata 14.0. Tuberculosis incidence rate was computed and described using frequency tables. Both bivariable and multivariable Cox proportional hazard models was fitted to identify predictors of TB. Results: Out of the 536 charts reviewed, 494 patient records were included in the analysis. A total of 62 patients have developed new TB cases during the follow up period of 1000.22 Person Years (PY); which gives an overall incidence rate of 6.19 cases per 100 PY (95% CI: 4.83 - 7.95). The highest rate was seen within the first year of follow up. TB free survival probability for the total cohort decreased with follow up year. Base line Hemoglobin < 10 g/dl (AHR= 5.25; 95% CI: 2.52 - 10.95), ambulatory/bedridden patients at enrolment (AHR = 2.31; 95% CI: 1.13 - 4.73), having fair or poor ART adherence (AHR = 3.22; 95% CI: 1.64 – 6.31) were increase the risk of tuberculosis whereas taking Isoniazid Preventive Therapy (IPT) (AHR = 0.33; 95% CI: 0.12 - 0.85) were protective factors of TB occurrence. Conclusion: TB Incidence was high among adults on ART especially in the first year of enrollment to ART. Low hemoglobin level, ambulatory or bedridden functional status, non-adherence to ART and IPT usage status were found to be independent predictors. Hence, continuous follow up for ART adherence and provision of IPT has a great importance to reduce the risk of TB. Key words: Ethiopia, Incidence, HIV Infection, TB/HIV infection

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Incidence and Predictors of Tuberculosis Occurrence among Adults on Antiretroviral Therapy at Debre Markos Referral Hospital, Northwest Ethiopia: Retrospective Follow-up Study

10.21203/rs.2.12735/v2 ◽

2020 ◽

Author(s):

Agazhe Aemro ◽

Abebaw Jember ◽

Degefaye Zelalem Anlay

Keyword(s):

Antiretroviral Therapy ◽

Incidence Rate ◽

Northwest Ethiopia ◽

Referral Hospital ◽

Hiv Care ◽

First Year ◽

Art Adherence ◽

Follow Up Study ◽

Debre Markos

Abstract Background: In resource limited settings, Tuberculosis (TB) is a major cause of morbidity and mortality among patients on antiretroviral treatment. Ethiopia is one of the 30 high TB burden countries. TB causes burden in healthcare system and challenge the effectiveness of HIV care. This study was to assess incidence and predictors of Tuberculosis among adults on antiretroviral therapy at Debre Markos Referral Hospital, Northwest Ethiopia, 2019. Methods: Institution based retrospective follow up study was conducted among adults on ART newly enrolled from 2014 to 2018 at Debre Markos Referral Hospital. Simple random sampling technique was used to select patients chart. Data was entered to EPI- INFO version 7.2.2.6 and analyzed using Stata 14.0. Tuberculosis incidence rate was computed and described using frequency tables. Both bivariable and multivariable Cox proportional hazard models was fitted to identify predictors of TB. Results: Out of the 536 patients chart reviewed, 494 patient records were included in the analysis. A total of 62 patients developed new TB cases during the follow up period of 1000.22 Person Years (PY); which gives an overall incidence rate of 6.19 cases per 100 PY (95% CI: 4.83 - 7.95). The highest rate was seen within the first year of follow up. After adjustment base line Hemoglobin < 10 g/dl (AHR= 5.25; 95% CI: 2.52 - 10.95), ambulatory/bedridden patients at enrolment (AHR = 2.31; 95% CI: 1.13 - 4.73), having fair or poor ART adherence (AHR = 3.22; 95% CI: 1.64 – 6.31) were associated with increased risk of tuberculosis whereas taking Isoniazid Preventive Therapy (IPT) (AHR = 0.33; 95% CI: 0.12 - 0.85) were protective factors of TB occurrence. Conclusion: TB incidence was high among adults on ART especially in the first year of enrollment to ART. Low hemoglobin level, ambulatory or bedridden functional status, non-adherence to ART and IPT usage status were found to be independent predictors. Hence, continuous follow up for ART adherence and provision of IPT has a great importance to reduce the risk of TB.

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Time to Development of Anemia and Predictors among HIV-Infected Patients Initiating ART at Felege Hiwot Referral Hospital, Northwest Ethiopia: A Retrospective Follow-Up Study

BioMed Research International ◽

10.1155/2020/7901241 ◽

2020 ◽

Vol 2020 ◽

pp. 1-7

Author(s):

Yibekal Manaye ◽

Anemaw Asrat ◽

Endalkachew Worku Mengesha

Keyword(s):

Pulmonary Tuberculosis ◽

Nutritional Status ◽

Northwest Ethiopia ◽

Referral Hospital ◽

First Year ◽

Follow Up Study ◽

Art Initiation ◽

Baseline Weight ◽

Felege Hiwot Referral Hospital

Introduction. Anemia is the most common hematological abnormality in Human Immunodeficiency Virus (HIV) clients, and it is a widespread public health problem. In Ethiopia, there is limited information about time to development of anemia and predictors for anemic HIV patients. Hence, this study is aimed at determining time to development of anemia and predictors among HIV/AIDS clients taking antiretroviral therapy (ART) at Felege Hiwot Referral Hospital in Bahir Dar, northwest Ethiopia. Methods. A retrospective follow-up study was conducted among clients on ART from 2012 to 2017. Data were collected using checklists. The Kaplan-Meier curve was employed to compare survival rates. The Cox proportional hazard model was applied to identify predictors of time to development of anemia. Results. A total of 490 ART patients were followed. The overall incidence of anemia was 27/100 person-years. The incidence was highest in the second year (18.7/100 PY) of starting ART when compared with the first year (13.8/100 PY) and third year (18.1/100 PY) of ART initiation. The independent predictors show an association for time to development of anemia and were as follows: being female (AHR=2.94, 95%CI=2.15–4.0), pulmonary tuberculosis positive (AHR=2.98, 95%CI=1.62–5.51), baseline weight<60 kg (AHR=1.51, 95%CI=1.19-1.92), and severe acute malnutrition (AHR=2.0, 95%CI=1.39-2.89). Conclusion. Most of the anemia cases occurred after the first year of ART initiation. Pulmonary tuberculosis, baseline weight, nutritional status, and sex were predictors for anemia. Clients with low baseline weight and abnormal nutritional status need to get close follow-up to prevent the risk of early development of anemia.

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Time to Detection of Anemia and Its Predictors Among Children Receiving Antiretroviral Therapy at Debre Tabor Referral Hospital and University of Gonder Compressive Specialized Hospital, 2020: A Multicenter Retrospective Follow-Up Study

10.21203/rs.3.rs-135419/v1 ◽

2021 ◽

Author(s):

Ermias Chanie ◽

Dejen feleke ◽

Sintayehu ehu Alemayehu ◽

Fisha GebreEyesus ◽

Aragaw Tesfaw ◽

...

Keyword(s):

Antiretroviral Therapy ◽

Incidence Rate ◽

Preventive Therapy ◽

Cd4 Count ◽

Referral Hospital ◽

Follow Up Study ◽

Specialized Hospital ◽

Debre Tabor ◽

Time To Detection

Abstract Background: Although antiretroviral therapy access for HIV infected children increased dramatically, anemia have been continued as a challenge regardless of cluster of differentiation (CD4) count and viral load. Hence, this study aimed to assess the time to detection of anemia and its predictors among children receiving antiretroviral therapy at Debre Tabor referral hospital and University of Gonder Compressive Specialized hospital, 2020.Methods: A retrospective follow-up study was conducted from January 2010 to December 2018. A total of 372 children under the age of 15 who had received ART were included in the study. Data were collected from children’s medical charts and ART registration logbook using a standard checklist. Besides, the data were entered into EPi data 4.2.2 and then exported to Stata 14.0 for further analysis. The Cox regression model, the variables having P-value ≤.05 with 95% CIs in multivariable analysis were declared as a statistically significant for anemia Result: The mean (±SD) of follow-up periods were 56.6 ±1.7 SD months. The overall median survival time free from anemia was 137 months, and the incidence rate of anemia was 6.9 per 100 PYO (95% CI: 5.3, 7.8). Moreover, WHO clinical staging of III/IV [AHR: 4.2, 95% CI: 1.80, 11.1], low CD4 count below threshold [AHR: 1.9, 95% CI: 1.09, 3.37], cotrimoxazole preventive therapy non-users, and poor level of adherence [(AHR: 2.4, 95% CI: 1.20, 4.85] were the main predictors of anemia. Conclusion: The incidence rate of anemia was found to be high. Monitor hemoglobin levels routinely with concurrently CD4 cell count levels, WHO clinical stage, and level of adherence. Hence, preventing and correcting of those predictors in a systematic manner in ongoing basis is crucial. Moreover, strategies need to be strengthened cotrimoxazole preventive therapy supplementation

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