Survival and Mortality Analysis for HIV Patients in Khartoum State, Sudan 2017
World Journal of Public Health
Volume 3, Issue 4, December 2018, Pages: 118-124
Received: Oct. 8, 2018; Accepted: Nov. 1, 2018; Published: Nov. 29, 2018
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Rania Hassan Abdelgafour Hassan, United Nation Population Fund (UNFPA), Khartoum, Sudan
Asma Abdellah Abdelaal, Department of Community Medicine, Faculty of Medicine, University of Khartoum, Khartoum, Sudan
Haidar Abuahmed Mohammed, Department of Community Medicine, Faculty of Medicine, University of Khartoum, Khartoum, Sudan
Malaz Ahmed Elbashir, United Nation Population Fund (UNFPA), Khartoum, Sudan
Khalid Badereldien Khalid, United Nation Population Fund (UNFPA), Khartoum, Sudan
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HIV epidemic in Sudan is low with prevalence of 0.3% among general population. The prevalence is higher among key population such as female sex workers and men having sex with men. Thirty percent of the estimated people living with HIV know their status, and 50% were on care by the end of 2016. Attrition rate in Sudan was highest in first 6 months, it was around 60% in 2014. This paper intends to conduct survival analysis for HIV/AIDS and investigate factors determining it, in Khartoum state, 2017. The study is retrospective cohort, facility based using data from the clinical records of adult HIV/AIDS patients who were enrolled in anti-retroviral therapy in Khartoum state between January and December 2015. Cox regression and Kaplan-Meier analyses were performed to examine factors that influence time to death and survival over time. Total of 547 people living with HIV on antiretroviral therapy- ART from all ART centres in Khartoum states during 2015 were included in the study, data collection and compilation was conducted in October 2017. The retention rate was (45.3%), AIDS related mortality rate was (9.9%), and lost to follow up rate was (37.1%). Cox regression model for mortality indicated significant association between survival and the following parameters: the functional status at start of ART (Hazard ratio - HR 4.765), alcohol use has (HR: 4.392), and world health organisation clinical stage at start of ART (HR: 1.859), all had negative impact on survival and increased risks for mortality. Literacy level status reduces mortality and increases survival time, as (HR: 0.338) and adherence to CTX (HR: 0.013). The study concluded that average survival time is significantly associated literacy level, duration between diagnosis and initiation of ART, functional status at start of ART, WHO stage at start of ART, and adherence to CTX. It is recommended that care providers showed modify existing follow up mechanisms to ensure provision of needed care to the patients with the identified determinants. In addition, the National HIV Guidelines should emphasize shortening the duration between diagnosis and linkage to care and early initiation of ART.
Anti-retroviral Therapy, HIV Survival Analysis, Determinants of HIV Mortality, Literacy Level, Functional Status, Initiation of ART, World Health Organization Clinical Stage
To cite this article
Rania Hassan Abdelgafour Hassan, Asma Abdellah Abdelaal, Haidar Abuahmed Mohammed, Malaz Ahmed Elbashir, Khalid Badereldien Khalid, Survival and Mortality Analysis for HIV Patients in Khartoum State, Sudan 2017, World Journal of Public Health. Vol. 3, No. 4, 2018, pp. 118-124. doi: 10.11648/j.wjph.20180304.13
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