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Survival and Mortality Analysis for HIV Patients in Khartoum State, Sudan 2017

Received: 8 October 2018     Accepted: 1 November 2018     Published: 29 November 2018
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Abstract

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.

Published in World Journal of Public Health (Volume 3, Issue 4)
DOI 10.11648/j.wjph.20180304.13
Page(s) 118-124
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2018. Published by Science Publishing Group

Keywords

Anti-retroviral Therapy, HIV Survival Analysis, Determinants of HIV Mortality, Literacy Level, Functional Status, Initiation of ART, World Health Organization Clinical Stage

References
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Cite This Article
  • APA Style

    Rania Hassan Abdelgafour Hassan, Asma Abdellah Abdelaal, Haidar Abuahmed Mohammed, Malaz Ahmed Elbashir, Khalid Badereldien Khalid. (2018). Survival and Mortality Analysis for HIV Patients in Khartoum State, Sudan 2017. World Journal of Public Health, 3(4), 118-124. https://doi.org/10.11648/j.wjph.20180304.13

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    ACS Style

    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 J. Public Health 2018, 3(4), 118-124. doi: 10.11648/j.wjph.20180304.13

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    AMA Style

    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 J Public Health. 2018;3(4):118-124. doi: 10.11648/j.wjph.20180304.13

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  • @article{10.11648/j.wjph.20180304.13,
      author = {Rania Hassan Abdelgafour Hassan and Asma Abdellah Abdelaal and Haidar Abuahmed Mohammed and Malaz Ahmed Elbashir and Khalid Badereldien Khalid},
      title = {Survival and Mortality Analysis for HIV Patients in Khartoum State, Sudan 2017},
      journal = {World Journal of Public Health},
      volume = {3},
      number = {4},
      pages = {118-124},
      doi = {10.11648/j.wjph.20180304.13},
      url = {https://doi.org/10.11648/j.wjph.20180304.13},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.wjph.20180304.13},
      abstract = {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.},
     year = {2018}
    }
    

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  • TY  - JOUR
    T1  - Survival and Mortality Analysis for HIV Patients in Khartoum State, Sudan 2017
    AU  - Rania Hassan Abdelgafour Hassan
    AU  - Asma Abdellah Abdelaal
    AU  - Haidar Abuahmed Mohammed
    AU  - Malaz Ahmed Elbashir
    AU  - Khalid Badereldien Khalid
    Y1  - 2018/11/29
    PY  - 2018
    N1  - https://doi.org/10.11648/j.wjph.20180304.13
    DO  - 10.11648/j.wjph.20180304.13
    T2  - World Journal of Public Health
    JF  - World Journal of Public Health
    JO  - World Journal of Public Health
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    EP  - 124
    PB  - Science Publishing Group
    SN  - 2637-6059
    UR  - https://doi.org/10.11648/j.wjph.20180304.13
    AB  - 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.
    VL  - 3
    IS  - 4
    ER  - 

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Author Information
  • United Nation Population Fund (UNFPA), Khartoum, Sudan

  • Department of Community Medicine, Faculty of Medicine, University of Khartoum, Khartoum, Sudan

  • Department of Community Medicine, Faculty of Medicine, University of Khartoum, Khartoum, Sudan

  • United Nation Population Fund (UNFPA), Khartoum, Sudan

  • United Nation Population Fund (UNFPA), Khartoum, Sudan

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