The Effect of Late Diagnosis on Hiv Related Mortality Among Adolescents in Public Hospitals of North Showa Zone Oromiya, Ethiopia; 2022: a Retrospective Cohort Study

Abstract

Abstract Background Late HIV diagnosis is the most prominent cause of HIV-related mortality, and also increases the risk of transmission and spread of the disease among society. Adolescents are the most vulnerable population’s age group for HIV infection in several settings but expanding access to early HIV testing remains a challenge. Consequently, a significant proportion of adolescents are still dying of HIV-related causes and the current study aimed at assessing the effect of late HIV diagnosis on HIV-related mortality among adolescents living with HIV. Methods Institutional based retrospective cohort study was conducted from August 21/2022-November 21/2022 at selected public hospitals in North Showa Zone of Oromiya. All newly diagnosed HIV positive adolescent, from September 1, 2012 to August 31, 2021, were included in the study. Data was entered into Epi-data version 3.1.1 and exported to Stata version 16 for further analysis. Both bi-variable and multivariable analyses were performed using Cox proportional hazard model to compare the HIV-related mortality of early diagnosed with late diagnosed adolescents using adjusted hazard ratio at 95% confidence interval (CI). Results A total of 341 medical records of adolescents were included in the study, contributing an overall incidence rate of 3.15 (95% CI: 2.21–4.26) deaths per 100 persons-years of observation throughout the total follow-up period of 1173.98 person-years. Adolescents with late diagnosis of HIV had three times the higher hazard of mortality (aHR = 3.00; 95% CI: 1.22–7.37) as compared to those with early diagnosis of HIV. Adolescents within the age of 15–19 years old (aHR = 3.56; 95% CI: 1.44–8.77), rural residence (aHR = 2.81; 95% CI: 1.39–5.68), poor adherence to ART (aHR = 3.17; 95% CI: 1.49–6.76) and being anemic (aHR = 3.09; 95% CI: 1.52–6.29) were other independent predictors of HIV-related mortality Conclusion The study found a substantial link between late HIV diagnosis and mortality among adolescents. Residence, age, ART medication adherence, and anemia status were also found to be other independent predictors of HIV-related mortality. To achieve the ultimate aim of lowering mortality among adolescents living with HIV, rigorous emphasis must be placed on early diagnosis of the diseases. In addition, counseling on adherence and prompt diagnosis and treatment of anemia are highly recommended to reduce the mortality.