Abstract:
Background: Human immunodeficiency virus and acquired immunodeficiency syndrome had created enormous challenges worldwide, continued to be the world’s serious health and development challenge. Globally, at the end 2017, there were 1.8 million children (<15 years) living with human immunodeficiency virus. The goal of antiretroviral therapy is to maintain maximal suppression of viral replication, to restore immune function, to reduce human immunodeficiency virus -related morbidity and mortality, and improve quality of life and prolong survival. The survival of HIV positive children treated with ART depends on a variety of factors, which might vary greatly with economic, socio- demographic, behavioral risk and health factor. Objectives: To assess Survival status and predictors of mortality among human immunodeficiency virus Positive Children on Antiretroviral Therapy at East Gojjam Zone Public hospitals, Amhara Regional State, Ethiopia 2019.Methods: An institution based retrospective cohort study was conducted in selected hospitals of East Gojjam zones among children aged less than 15years who were newly enrolled in human immunodeficiency virus care clinic from January1st 2014 to December 31, 2018. Data was collected using standardized check list. The charts were reviewed during March 1 to 22,2019. Data was entered Epi-Data version 3.1 and then exported to SPSS version 24 for statistical analysis. A Kaplan Meier curve and long rank test were used to estimate the survival time and compare survival curves between variables. Multivariable Cox proportional hazards model was fitted to identify predictors of survival status and variables having p value < 0.05 were considered as statistically significant. Result: In this study, a total of 251 HIV positive children on ART were followed up for a total of 60 months, with a mean (SD) survival time of 55.54(+ 0.83), (95% CI:53.90-57.17) months. The overall mortality incidence rate in the cohort during the 626 Child-year- observation (CYO) was 2.56/100 CYO. Kaplan- estimation Meier survival showed that overall estimated survival probability after starting ART was 0 .90 at 60 months of follow up. In this study age, hemoglobin level, CD4 count, cotrimoxazole preventive therapy (CPT), weight for height were statistically significant predictors of survival status (P <0.05). Conclusion and Recommendation: Age < 5 years, CD4 count, Hgb <10gm/dl, WFH (z<-3), not taking cotrimoxazole preventive therapy were an independent predictor of mortality. Therefore, concerned stakeholders should focus on above mentioned predictors of mortality and nutritional interventions to enhance survival of HIV-infected children on antiretroviral therapy.