Wolelaw Endeshaw Habtamu, Hiruy Endalk Getasew, Abdu Asiya Mohammed, Mihretie Kebadnew Mulatu
Gambela University, Gambela, Ethiopia.
College of Medicine and Health Sciences Department of Nursing, Debre Markos University, Debre Markos, Ethiopia.
BMC Infect Dis. 2025 Apr 10;25(1):500. doi: 10.1186/s12879-025-10878-7.
In patients who have tuberculosis and the human immunodeficiency virus, Tuberculosis is the most prevalent opportunistic illness and the main cause of death. However, little is currently, the time to death and its predictors are known, particularly among individuals with coinfection in the study area. Therefore, this study was aimed fill this gap in the region.
To assess the incidence of death and its predictors among tuberculosis patients and humans immunodeficiency virus coinfected adult patients receiving antiretroviral therapy in Gambella Referral Hospital, Southwest Ethiopia, 2022.
This Retrospective cohort study included 320 coinfected adult patients on antiretroviral therapy from June 2017 to June 2022. Data were extracted from the document by using a structured checklist adapted and prepared on the basis of the charts. Death is the event, whereas not having experienced death is censored. The data were entered in to Epi-data version 3.1 and then export to STATA version 14. Kaplan- Meier curve and log rank tests were used to compare the survival curves and estimate survival time. Cox regression model was used to identify significant predictors of death. A Cox-Snell residual plot was used to measure the Cox model goodness of fit.
The cumulative mortality rate for the 320 coinfected individuals that were monitored was 14.7%, with an incidence rate of 6.7 deaths per 1000 person-months (95% CI: 5.0-8.9). Individuals with low adherence to ART who are female (AHR 2.1, 95%CI: 1.05-4.21). In contrast, non-users of cotrimoxazole treatment (AHR = 4.03, 95%CI: 1.99-. The risk of death was greater for those with a viral load > 1000 copes/ml (AHR: 3.18, 95%CI: 1.19-8.52).
In comparison to Ethiopia's 2021 death rate, the study area's mortality incidence rate was high. There was a higher risk of death for ART-using female patients, those with poor ART adherence, those with an opportunistic infection other than tuberculosis, those with a viral load value between 50 and 1000 copies per milliliter and more than 1000 copies per milliliter, and those who did not use cotrimoxazole prophylactic therapy. Therefore, extensive monitoring and counseling can be beneficial for patients with virus loads greater than 1000 copies/ml, non-CPT users, females, and poor ART adherence.
在患有结核病和人类免疫缺陷病毒的患者中，结核病是最常见的机会性疾病和主要死因。然而，目前关于死亡时间及其预测因素知之甚少，尤其是在研究区域的合并感染个体中。因此，本研究旨在填补该地区的这一空白。
评估2022年在埃塞俄比亚西南部甘贝拉转诊医院接受抗逆转录病毒治疗的结核病患者和人类免疫缺陷病毒合并感染成年患者的死亡率及其预测因素。
这项回顾性队列研究纳入了2017年6月至2022年6月期间320名接受抗逆转录病毒治疗的合并感染成年患者。通过使用根据图表改编和编制的结构化清单从文件中提取数据。死亡为事件，未经历死亡则为删失。数据录入Epi-data 3.1版本，然后导出到STATA 14版本。采用Kaplan-Meier曲线和对数秩检验比较生存曲线并估计生存时间。使用Cox回归模型确定死亡的显著预测因素。使用Cox-Snell残差图来衡量Cox模型的拟合优度。
监测的320名合并感染个体的累积死亡率为14.7%，发病率为每1000人月6.7例死亡（95%CI：5.0-8.9）。女性且抗逆转录病毒治疗依从性低的个体（调整后风险比2.1，95%CI：1.05-4.21）。相比之下，未使用复方新诺明治疗的个体（调整后风险比=4.03，95%CI：1.99-）。病毒载量>1000拷贝/ml的个体死亡风险更高（调整后风险比：3.18，95%CI：1.19-8.52）。
与埃塞俄比亚2021年的死亡率相比，研究区域的死亡率发病率较高。接受抗逆转录病毒治疗的女性患者、抗逆转录病毒治疗依从性差的患者、患有除结核病以外的机会性感染的患者、病毒载量值在每毫升50至1000拷贝之间以及超过1000拷贝/毫升的患者，以及未使用复方新诺明预防性治疗的患者死亡风险更高。因此，对病毒载量大于1000拷贝/ml的患者、未使用复方新诺明的患者、女性患者和抗逆转录病毒治疗依从性差的患者进行广泛监测和咨询可能有益。
