GBV determinants of survival of HIV-haart naive patients to haart initiation at bondo sub-county hospital: a two year retrospective cohort study.

Abstract

HIV-AIDS remains a major public health issue in Kenya with a prevalence of 5.3% and contributing to 29% of annual mortality. Despite marked improvement in the provision for care and treatment a search for improvement of the current care and treatment programs will lead to better health outcomes. Purpose: Various factors influence the prognosis of HIV disease however minimal research has been conducted to determine how the information gathered on enrollment influence the illness prognosis. The early identification of how this information can inform disease prognosis will aid in improving management strategies and increase quality of life of the HIV infected. The aim of this research was to determine how the collected information influence times to HAART eligibility and determine factors that influence this duration. Materials and methods: The study was a retrospective cohort study that was carried out in the Bondo sub county hospital CCC. Primary data was collected from patient treatment files, in the period beginning January 2013 to December 2014 in to the data collection forms then entered into Microsoft excel, cleaned and transferred to Stata 13 for survival analysis. Results: In the study period 2015 patients were enrolled and 164 (female=93, male =71) satisfied the inclusion and exclusion criteria. The medium survival time was 65days. The WHO stage of enrollment (p-value <0.0000) and age of enrollment (p-value 0.006) were found to be the major determinants of the time to HAART eligibility. Discussion: The WHO stages of enrollment and age of enrollment were strongly associated with HIV prognosis and this could be attributed to level of immune status which is affected by both this factors. Conclusion: Age of enrollment and WHO stage of enrollment were the main variables captured in MOH 257 that inform on HIV-HAART naïve disease progression to HAART eligibility. Recommendation: This study needs to be done in a prospective study incorporating time dependent covariates so as to give a clear picture of the other covariates not picked in this study