Abstract: Although treatment with antiretrovirals makes it possible to control infection with Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS), this pandemic remains a global health problem, especially in sub-Saharan Africa. According to the 2018 UNAIDS report, 37.9 million people globally were living with HIV in the world. Among that, 25.6 million were located in Africa, i.e., 67.5% (20.6 million in East and South Africa and 5 million in West and Central Africa). New infections represent 1.08 million in Africa out of 1.7 million in the world in the same year, i.e., 63.5% (0.8 million in East and South Africa and 0.28 million in West and Central Africa) while deaths related due to AIDS for the same year represent 61% in Africa. The purpose of this research is to estimate and compare survival function of different groups of HIV-infected people. The aim is also to estimate instantaneous risk of death and its determinants in HIV people infected in Burundi. That could ensure effective care and better prevention against this scourge through the reorientation and/or strengthening of interventions carried out by the various actors. However, the subjects are included in the study on a staggered basis and the participation period for each is calculated from the date of inclusion until the point date or the date of the last information.
Methods. A retrospective cohort study of HIV/AIDS patients receiving Anti Retroviral Therapy (ART) at the “Association Nationale de Soutien aux Spositifs et Malades du SIDA” (ANSS) is conducted. To compare the survival of various groups, a Kaplan-Meier survival analysis was performed. The log rank test allowed us to verify if the survival difference between groups, if it exists, is significant. The Cox proportional hazards model is used to identify factors influencing HIV/AIDS patient survival rates. Evaluation criterion is the death. Significance level is set at 5%.
Results. A total of 6888 patients were enrolled in the study. The average follow-up period is 65.2 months. After multivariate analysis, age range at admission [a Hazard Ratio (aHR) 15-50 years old range is equal to 0.48, with p = 2.07e-09 while aHR under 15 years old range is 0.35 with p = 1.29e-06] refer to the elderly patients, more than 50 years old; sex[aHR: 1.5, p = 6.30e-05]; sector of activity [aHR without sector of activity: 1.2, p = 0.08, aHR secondary sector: 1.3, p = 0.03] refer to people in the primary sector of activity and WHO stage [aHR stage 3: 2.3, p = 3.75e-10, aHR stage 4: 3.5, p = 2.26e-10] refer to the WHO stage 1 were independently and significantly associated with survival.
Conclusion. According to the results of this study, specific interventions for men and patients over the age of 50 are necessary to ensure effectiveness care of HIV at the ANSS. In addition, implementation projects to find income-generating activities to all People Living With HIV (PLWHIV) would also be a way of providing to them their basic needs. Finally, the early testing of people infected with HIV is necessary to take care of HIV infection from the less advanced World Health Organisation (WHO) stage.
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Keywords and phrases: HIV/AIDS, therapeutic and psychological care, survival, ANSS, Burundi.
Received: August 23, 2023; Accepted: November 9, 2023; Published: January 25, 2024
How to cite this article: Ladislas NDABARUSHIMANA, Papa NGOM, Abdou Ka DIONGUE, Oumy NIASS and Anabelle NIYONGABO, Survival comparison of groups of people living with infection of HIV/AIDS and failure factors of treatment in the structure of therapeutic and psychological care, ANSS in Burundi, Far East Journal of Theoretical Statistics 68(1) (2024), 117-145. http://dx.doi.org/10.17654/0972086324007
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