Mortality trend and associated factors among HIV clients on antiretroviral therapy in Tanzania from 2018-2020

  • Sexually Transmitted Diseases
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Studies on Antiretroviral therapy programs in Africa have shown a significant reduction of mortality among HIV clients. Mortality trend among HIV clients on Antiretroviral therapy (ART) in Tanzania from 2018 to 2020 and factors associated with it are poorly described. The aim of the present study was to assess mortality trends and to identify predictors of mortality in HIV-infected clients on ART from 26 regions in Tanzania mainland

Observational analysis of data from HIV-positive clients obtaining care and treatment from health facilities in Tanzania mainland, Data were reviewed for mortality from January 2018 to December 2020. The proportional death by age, sex, ART program year, marital status, clinical stage, and zones, were summarized using cross-tabulation and Pearson's chi-squared for significance. Logistic regression was used to determine the baseline predictors of mortality at bivariate and multivariate levels, respectively.

A total 29982 study participants were randomly selected from each program year making a total of 89946 participants from 2018-2020, The annual specific mortality was 5.9%, 4.3%, and 3.1% in 2018, 2019, and 2020 respectively. Mortality was significantly associated with malnutrition AOR= 2.1 (95% CI 1.4 – 3.1), Being a male AOR=2.0 (95% CI: 1.6-3.9), participants with active TB or history of TB treatment AOR= 1.7 (95% CI: 1.4-6.6), WHO clinical stage (3) AOR=2.2 (1.5-3.3), WHO clinical stage (4) AOR=7.3 (3.9-13.7) and CD4 count less than 200cells/mm3 AOR=1.7(95% CI: 1.31-2.3)

Mortality trend in Tanzania was seen to decrease with time from 2018 to 2020. Most deaths occurred among male clients, clients with advanced diseases (WHO stage 3 and 4), TB coinfection, CD4 count <200 cells/μl, and those with malnutrition. This mortality would be further reduced by improving TB screening and treatment, nutritional support, and promoting early diagnosis and treatment of HIV infection.

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