المستودع الأكاديمي جامعة المدينة

Risk Factors for High Early Mortality in Patients on Antiretroviral Treatment in a Rural District of Malawi.

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dc.contributor Medecins sans Frontieres, Operational Research, Brussels Operational Center, Belgium. zachariah@internet.lu
dc.creator Zachariah, R
dc.creator Fitzgerald, M
dc.creator Massaquoi, M
dc.creator Pasulani, O
dc.creator Arnould, L
dc.creator Makombe, S D
dc.creator Harries, A D
dc.date 2006-11-28
dc.date.accessioned 2017-01-31T07:09:56Z
dc.date.available 2017-01-31T07:09:56Z
dc.identifier Risk Factors for High Early Mortality in Patients on Antiretroviral Treatment in a Rural District of Malawi. 2006, 20 (18):2355-60 AIDS
dc.identifier 0269-9370
dc.identifier 17117022
dc.identifier 10.1097/QAD.0b013e32801086b0
dc.identifier http://hdl.handle.net/10144/18297
dc.identifier http://fieldresearch.msf.org/msf/handle/10144/18297
dc.identifier AIDS (London, England)
dc.identifier.uri http://dspace.mediu.edu.my:8181/xmlui/handle/10144/18297
dc.description OBJECTIVES: Among adults started on antiretroviral treatment (ART) in a rural district hospital (a) to determine the cumulative proportion of deaths that occur within 3 and 6 months of starting ART, and (b) to identify risk factors that may be associated with such mortality. DESIGN AND SETTING: A cross-sectional analytical study set in Thyolo district, Malawi. METHODS: Over a 2-year period (April 2003 to April 2005) mortality within the first 3 and 6 months of starting ART was determined and risk factors were examined. RESULTS: A total of 1507 individuals (517 men and 990 women), whose median age was 35 years were included in the study. There were a total of 190 (12.6%) deaths on ART of which 116 (61%) occurred within the first 3 months (very early mortality) and 150 (79%) during the first 6 months of initiating ART. Significant risk factors associated with such mortality included WHO stage IV disease, a baseline CD4 cell count under 50 cells/mul and increasing grades of malnutrition. A linear trend in mortality was observed with increasing grades of malnutrition (chi for trend = 96.1, P </= 0.001) and decreasing CD4 cell counts (chi for trend = 72.4, P </= 0.001). Individuals who were severely malnourished [body mass index (BMI) < 16.0 kg/m] had a six times higher risk of dying in the first 3 months than those with a normal nutritional status. CONCLUSIONS: Among individuals starting ART, the BMI and clinical staging could be important screening tools for use to identify and target individuals who, despite ART, are still at a high risk of early death.
dc.language en
dc.rights Published by Wolters Kluwer Lippincott Williams & Wilkins - Archived on this site by kind permission Wolters Kluwer
dc.title Risk Factors for High Early Mortality in Patients on Antiretroviral Treatment in a Rural District of Malawi.


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