PREDICTORS OF SURVIVAL TIMEAMONG CHILDREN ON ANTIRETROVIRAL THERAPY IN DILCHORA REFERRAL HOSPITAL, DIRE DAWA, EAST ETHIOPIA

Abstract

Background: Early death of children with Human Immunodeficiency Virus (HIV) infected is still high, although they are taking anti-retroviral therapy. However, little evidence was found on predictors of survival time among children living with HIV after initiation of Anti Retroviral Therapy in Dire Dawa, East Ethiopia. Objective: Toidentify predictors of survival time among children started antiretroviral treatmentin Dilchora referral hospitalfromJanuary 15, 2019 to February 28, 2019. Methods: A retrospective cohort study was conducted among eligible children in Dilchora referral hospital started ART from Jan 1, 2012 to Dec 31, 2018. Random sample of 315 medical records included. Data was collected using a pretested data extraction format. It was entered to EpiData software Version 3.1 checked, validated and exported to SPSS Version 23 for analysis using life table, Kaplan Meir test and Cox proportional hazard regression. Results: Out of 315 reviewed medical records of children, 53(16.8%) died and others censored.The mean age (standard deviation) of study participants was 90.8(50.1) months. The mean survival time of the study participants was 68 months (95% CI, 64.3-71.58). Fair/poor ART adherence of children AHR 4.34(95% CI, 1.97-9.58), hemoglobin level less than 10 g/dl(AHR 2.02(95% CI, 1.06-3.87) anddelayed/regressed developmental milestone status (CHR=0.41, 95% CI: 0.19-.90) were associated more likely to die. Children that were presented with WHO staging IV (AHR=4.45, 95% CI, 1.10 -10.80,) and stage III (AHR=3.43, 95% CI, 1.25-9.39) had higher chance of death than those presented at stage (I/II).Risk of death was 3.5 times (AHR=3.55, 95% CI, 1.59- 7.91) higher among patient with CD4 count below threshold. Conclusion:The meansurvival time of the study participants was 68 months. Fair/poor ART adherence, low hemoglobin level, delayed/regression developmental milestone, higher WHO stage at initiation of ART and low CD4 count were independent predictors of decreased survival time.