Survival Time To Death And Its Predictors Among Tuberculosis Patients Who Have Started Anti-tb Treatment In Selected Health Centers Of Addis Ababa Ethiopia A Retrospective Cohort Study

Background: Tuberculosis remains the leading cause of morbidity and mortalityrnglobally and in Ethiopia despite different strategies have been designed and implemented rnto combat it. Survival time and its predictors among tuberculosis patients who enrolled torncare in selected health centers in Addis Ababa were assessed. rnMethod: A retrospective cohort study was conducted in 20 selected health centers ofrnAddis Ababa city, Ethiopia. Data were collected from April 1 to August 30, 2018 by rnreviewing medical records of tuberculosis patients who were registered from May 2016rnto May 2017. Statistical software STATA version 14 was used for analysis of the data.rnKaplan–Meier curve and log-rank test was employed to investigate the statisticalrnsignificance of the difference in survival experience among different categories ofrnpatients. Cox-proportional hazard and accelerated failure time model was used to assessrnthe relationship between baseline variables and mortality. The strength of association wasrnpresented by hazard ratio with 95% CI and results were reported significant at P ≤ 0.05. rn Results: The medical records of 371 patients were included in the analysis of whichrn136 (36.7 %) died during the treatment period. Majority of TB deaths occurred withinrntwo months of the start of treatment and the overall estimated median survival time wasrn157 days. Based on akaikie information criterion, weibull accelerated failure time modelrnmanifested better results as compared with other models. In multivariable weibull model,rnage (HR=0.98, P=0.04), baseline weight (HR=0.96, P=0.03), tuberculosis treatmentrnphase (continuation phase, HR=0.48, P≤0.01) and tuberculosis type (pulmonary negativernTB, HR=19.92, P≤0.01) were found to be independent predictors of time to death ofrntuberculosis patients. rnConclusions: Most of the patients died at the end of study period. This warrants that,rnspecial attention and follow up with nutritional support for pulmonary negative patients rnand underweight patients to reduce deaths and for better clinical and treatment outcome.

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