Incidence of death and its predictors among/HIV co-infected adult patients on anti-retro viral therapy at Gambelia referral hospital, Southwest, Ethiopia

Incidence of death and its predictors among/HIV co-infected adult patients on anti-retro viral therapy at Gambelia referral hospital, Southwest, Ethiopia | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Incidence of death and its predictors among/HIV co-infected adult patients on anti-retro viral therapy at Gambelia referral hospital, Southwest, Ethiopia Endeshaw Habtamu, Endalk Getasew Hiruy, Kebadnew Mulatu, Asiya Mohammed This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4918131/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 10 Apr, 2025 Read the published version in BMC Infectious Diseases → Version 1 posted 4 You are reading this latest preprint version Abstract Background : In patients who have tuberculosis and the human immunodeficiency virus, tuberculosis is the most prevalent opportunistic illness and the main killer. However, little is currently known about time to death and its predictors, particularly among individuals with coinfection in the study area. Therefore, this study was aimed at filling this gap in the region. Objective: To assess incidence of death and its predictors among tuberculosis and human immunodeficiency virus co-infected adult patients on anti-retroviral therapy in Gambella Referral Hospital, Southwest Ethiopia, 2023. Methods : Retrospective cohort study was conducted in 320 co-infected adult patients on antiretroviral therapy from June 2017 to June 2022. Data were extracted from the document by using structured checklist those adapted and prepared based on the charts. Death is the event, whereas not having experienced death is censored. Data was entered in to Epi-data version 3.1 then export to STATA version 14. Kaplan Meier curve and log rank test was used to compare the survival curves and estimate survival time. Cox regression model was used to identify significant predictors of death. Cox-Snell residual plot was used to measure cox model goodness of fit. Results : A total of 320 co-infected patients were followed with cumulative incidence of death are 14.7% and 6.7 deaths per 1000 person-months as the incidence rate (95%CI: 5.0-8.9). Patients who are being female (AHR 2.1, 95%CI: 1.05-4.21), with poor adherence to ART (AHR=5.88, 95%CI: 2.69-12.86), non-cotrimoxazole therapy users (AHR=4.03, 95%CI: 1.99- 8.16) and viral load >1000copes/ml (AHR: 3.18, 95%CI: 1.19-8.52) were at higher risk of death. Conclusion and Recommendation : In the study area, the incidence rate of mortality was high compared to incidence rate of mortality in Ethiopia 2021. Patients on ART who are being female, had poor ART adherence, had an opportunistic infection other than tuberculosis, had a viral load value between 50 and 1000 copies per milliliter and greater than 1000 copies per milliliter, and non-cotrimoxazole prophylaxis therapy users were increased risk of deaths. As a result, patients with viral loads >000copes/ml, non-CPT users, who are being female, and who had poor ART adherence can benefit from intensive monitoring and counseling. Incidence of death TB/HIV Co-infection Anti-Retroviral Therapy Mortality Figures Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 Figure 7 Full Text Additional Declarations No competing interests reported. Tables 1-5 are available in the Supplementary Files section. Supplementary Files Tables.docx Cite Share Download PDF Status: Published Journal Publication published 10 Apr, 2025 Read the published version in BMC Infectious Diseases → Version 1 posted Editorial decision: Revision requested 23 Aug, 2024 Editor assigned by journal 19 Aug, 2024 Submission checks completed at journal 18 Aug, 2024 First submitted to journal 15 Aug, 2024 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4918131","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":344199825,"identity":"96b0ccb7-0aa3-4151-ad22-5da71f130158","order_by":0,"name":"Endeshaw 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Hospital between June 2017 and June 2022.\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"3.png","url":"https://assets-eu.researchsquare.com/files/rs-4918131/v1/f44655735df68a2bdda2c10f.png"},{"id":66553799,"identity":"15e2a46a-2a7d-49d0-a588-12e7db2f51f7","added_by":"auto","created_at":"2024-10-14 09:15:04","extension":"png","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":18577,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eKaplan-Meier survival estimates based on their sex during the follow up time among TB/HIV co-infected adult patients on ART in Gambella General Hospital between June 2017 and June 2022\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"4.png","url":"https://assets-eu.researchsquare.com/files/rs-4918131/v1/2d6a3b65e28bbb6bc52a222a.png"},{"id":66551376,"identity":"7af2b81d-f300-4ffd-a734-acf3d362efce","added_by":"auto","created_at":"2024-10-14 09:07:04","extension":"png","order_by":5,"title":"Figure 5","display":"","copyAsset":false,"role":"figure","size":21691,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eKaplan-Meier survival estimates based on their ART adherence during the follow up time among TB/HIV co-infected adult patients on ART in Gambella Referral Hospital between June 2017 and June 2022.\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"5.png","url":"https://assets-eu.researchsquare.com/files/rs-4918131/v1/18bcf2b887388f8337c9cbde.png"},{"id":66553800,"identity":"70df3ccb-63c5-4b1d-befb-283482f55476","added_by":"auto","created_at":"2024-10-14 09:15:04","extension":"png","order_by":6,"title":"Figure 6","display":"","copyAsset":false,"role":"figure","size":21620,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eKaplan-Meier survival estimates based on their viral load during the follow up time among TB/HIV co-infected adult patients on ART in Gambella Referral 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16:17:41","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":952905,"visible":true,"origin":"","legend":"","description":"","filename":"RevisedManusIncidenceofdeathTBHIV.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4918131/v1_covered_ddb606bf-da81-41b2-8cd1-3e85212d6472.pdf"},{"id":66551371,"identity":"f114b594-a583-4034-b6ff-e462e0792d2a","added_by":"auto","created_at":"2024-10-14 09:07:04","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":40929,"visible":true,"origin":"","legend":"","description":"","filename":"Tables.docx","url":"https://assets-eu.researchsquare.com/files/rs-4918131/v1/7947d832341c29dec7b2a499.docx"}],"financialInterests":"\u003cp\u003eNo competing interests reported.\u003c/p\u003e\n\u003cp\u003eTables 1-5 are available in the Supplementary Files section.\u003c/p\u003e","formattedTitle":"Incidence of death and its predictors among/HIV co-infected adult patients on anti-retro viral therapy at Gambelia referral hospital, Southwest, Ethiopia","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-infectious-diseases","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"infd","sideBox":"Learn more about [BMC Infectious Diseases](http://bmcinfectdis.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/infd","title":"BMC Infectious Diseases","twitterHandle":"#bmcinfectdis","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Incidence of death, TB/HIV, Co-infection, Anti-Retroviral Therapy, Mortality","lastPublishedDoi":"10.21203/rs.3.rs-4918131/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4918131/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground\u003c/strong\u003e: In patients who have tuberculosis and the human immunodeficiency virus, tuberculosis is the most prevalent opportunistic illness and the main killer. However, little is currently known about time to death and its predictors, particularly among individuals with coinfection in the study area. Therefore, this study was aimed at filling this gap in the region. Objective: To assess incidence of death and its predictors among tuberculosis and human immunodeficiency virus co-infected adult patients on anti-retroviral therapy in Gambella Referral Hospital, Southwest Ethiopia, 2023.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods\u003c/strong\u003e: Retrospective cohort study was conducted in 320 co-infected adult patients on antiretroviral therapy from June 2017 to June 2022. Data were extracted from the document by using structured checklist those adapted and prepared based on the charts. Death is the event, whereas not having experienced death is censored. Data was entered in to Epi-data version 3.1 then export to STATA version 14. Kaplan Meier curve and log rank test was used to compare the survival curves and estimate survival time. Cox regression model was used to identify significant predictors of death. Cox-Snell residual plot was used to measure cox model goodness of fit.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e: A total of 320 co-infected patients were followed with cumulative incidence of death are 14.7% and 6.7 deaths per 1000 person-months as the incidence rate (95%CI: 5.0-8.9). Patients who are being female (AHR 2.1, 95%CI: 1.05-4.21), with poor adherence to ART (AHR=5.88, 95%CI: 2.69-12.86), non-cotrimoxazole therapy users (AHR=4.03, 95%CI: 1.99- 8.16) and viral load \u0026gt;1000copes/ml (AHR: 3.18, 95%CI: 1.19-8.52) were at higher risk of death.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion and Recommendation\u003c/strong\u003e: In the study area, the incidence rate of mortality was high compared to incidence rate of mortality in Ethiopia 2021. Patients on ART who are being female, had poor ART adherence, had an opportunistic infection other than tuberculosis, had a viral load value between 50 and 1000 copies per milliliter and greater than 1000 copies per milliliter, and non-cotrimoxazole prophylaxis therapy users were increased risk of deaths. As a result, patients with viral loads \u0026gt;000copes/ml, non-CPT users, who are being female, and who had poor ART adherence can benefit from intensive monitoring and counseling.\u0026nbsp;\u003c/p\u003e","manuscriptTitle":"Incidence of death and its predictors among/HIV co-infected adult patients on anti-retro viral therapy at Gambelia referral hospital, Southwest, Ethiopia","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-10-14 09:06:59","doi":"10.21203/rs.3.rs-4918131/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2024-08-23T12:58:38+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2024-08-19T10:12:03+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2024-08-18T23:24:08+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Infectious Diseases","date":"2024-08-15T08:39:42+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-infectious-diseases","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"infd","sideBox":"Learn more about [BMC Infectious Diseases](http://bmcinfectdis.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/infd","title":"BMC Infectious Diseases","twitterHandle":"#bmcinfectdis","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"ba1754b1-5f88-4a9e-965c-156236bf006f","owner":[],"postedDate":"October 14th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2025-04-14T16:14:24+00:00","versionOfRecord":{"articleIdentity":"rs-4918131","link":"https://doi.org/10.1186/s12879-025-10878-7","journal":{"identity":"bmc-infectious-diseases","isVorOnly":false,"title":"BMC Infectious Diseases"},"publishedOn":"2025-04-10 16:05:12","publishedOnDateReadable":"April 10th, 2025"},"versionCreatedAt":"2024-10-14 09:06:59","video":"","vorDoi":"10.1186/s12879-025-10878-7","vorDoiUrl":"https://doi.org/10.1186/s12879-025-10878-7","workflowStages":[]},"version":"v1","identity":"rs-4918131","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4918131","identity":"rs-4918131","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}