GBV Determinants of Survival of HIV-HAART Naive Patients to HAART Initiation at Bondo Sub-County Hospital: A Two Year Retrospective Cohort Study

Abstract

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 may lead to better health outcomes. Various factors influence the prognosis of HIV disease. However, minimal research has been conducted to determine information gathered on enrollment influence HIV-AIDS prognosis. Early identification of how information can inform disease prognosis may aid in improving management strategies and increase quality of life of the HIV infected patients. This research aimed at determining how collected information influence times to HAART eligibility and factors influencing this duration. A retrospective cohort study was carried out in Bondo Sub County Hospital Comprehensive Care Centre. Primary data was collected from patient treatment files, in the period beginning 1st January 2013 to 31st December 2014 in data collection forms entered in Microsoft Excel, cleaned and transferred to Stata ver 13 for survival analysis. In the study period 2015 patients were enrolled and 164 (female=93, male =71) satisfied the inclusion criteria. The medium survival time was 65 days. The WHO stage of enrollment (p = 0.0000) and age of enrollment (p = 0.006) were found to be the major determinants of the time to HAART eligibility. 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. 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. 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.