Incidence of death and its predictors among/HIV co-infected adult patients on anti-retro viral therapy at Gambelia referral hospital, Southwest, Ethiopia

Background : In patients who have tuberculosis and the human immunodeficiency virus, tuberculosis is the most prevalent opportunistic illness and the main killer. However, little is currently known about time to death and its predictors, particularly among individuals with coinfection in the study area. Therefore, this study was aimed at filling this gap in the region. Objective: To assess incidence of death and its predictors among tuberculosis and human immunodeficiency virus co-infected adult patients on anti-retroviral therapy in Gambella Referral Hospital, Southwest Ethiopia, 2023. Methods : Retrospective cohort study was conducted in 320 co-infected adult patients on antiretroviral therapy from June 2017 to June 2022. Data were extracted from the document by using structured checklist those adapted and prepared based on the charts. Death is the event, whereas not having experienced death is censored. Data was entered in to Epi-data version 3.1 then export to STATA version 14. Kaplan Meier curve and log rank test was used to compare the survival curves and estimate survival time. Cox regression model was used to identify significant predictors of death. Cox-Snell residual plot was used to measure cox model goodness of fit. Results : A total of 320 co-infected patients were followed with cumulative incidence of death are 14.7% and 6.7 deaths per 1000 person-months as the incidence rate (95%CI: 5.0-8.9). Patients who are being female (AHR 2.1, 95%CI: 1.05-4.21), with poor adherence to ART (AHR=5.88, 95%CI: 2.69-12.86), non-cotrimoxazole therapy users (AHR=4.03, 95%CI: 1.99- 8.16) and viral load >1000copes/ml (AHR: 3.18, 95%CI: 1.19-8.52) were at higher risk of death. Conclusion and Recommendation : In the study area, the incidence rate of mortality was high compared to incidence rate of mortality in Ethiopia 2021. Patients on ART who are being female, had poor ART adherence, had an opportunistic infection other than tuberculosis, had a viral load value between 50 and 1000 copies per milliliter and greater than 1000 copies per milliliter, and non-cotrimoxazole prophylaxis therapy users were increased risk of deaths. As a result, patients with viral loads >000copes/ml, non-CPT users, who are being female, and who had poor ART adherence can benefit from intensive monitoring and counseling.