dc.description.abstract |
The illnesses tuberculosis (TB) and the human immunodeficiency virus/acquired
immune deficiencies syndrome (HIV/AIDS), which result in approximately 10 million
illnesses and 1.45 million fatalities each year, account for a sizeable share of the global
burden. HIV survival rates are decreased by co-infection with TB because it is more
difficult to manage and treat HIV. The objective of the project was to mimic in a few
Kenyan counties the spatial-temporal survival dynamics of patients who also had TB
and HIV infections. The study's specific objectives included comparing the survival
rates of patients receiving ART and TB treatment in a few Kenyan counties with those
receiving ART alone, analyzing geographic variations in associated patient deaths,
demonstrating the spatial-temporal the distributions of HIV/TB fatalities, and using a
Bayesian model to look into regional/county demographic factors associated with
survival rates in a few Kenyan counties. A retrospective collaborative research
methodology was used in the project. The patients who received co-therapy for TB and
ART maintenance at medical hospital through January 1, 2015, and December 31,
2019, comprised the target population. This information was compiled using the
National AIDS & STIs Control Program (NASCOP) database, which contains all the
records of patients from the chosen Kenyan counties that had associated with HIV and
TB. The Kaplan-Meier estimator was used to calculate the survival function. A Cox
Proportional Hazard Regression Analysis was fitted in a multivariate analysis to assess
subject survival trends and the influence of covariates on survival time. The fit of the
data to the Cox proportionate hazard regression model is given by the log component
likelihood function. The hazard ratios for every covariate data, under consideration
were tested for statistical significance using the Log-rank, Score, and Wald tests. A
Bayesian model was created to display the temporal and spatial variance in mortality
hazard by County in Kenya. STATA 14.2 and Bayes 3.0.2 were used for the analysis.
The results showed that 2,555 (7.9%) of the HIV and TB patients in Kenya reported
passing away five years after starting ART. The mean duration of event incidence for
the category receiving both ART and treatment for TB was 4 years, according to the
mean surviving time for the resultant (dead) cases of 4 years. The study's log-rank test
showed a p-value of 0.00, indicating that the two curves were statistically independent
from one another. The p-value of 0.000, which was lower than the value of the p- value
at the 5% significance threshold, demonstrates this. The probabilistic survival of those
with HIV and TB mutual infection is thus impacted by ART and TB treatment. More
persons with TB and HIV illnesses survived more time when they obtained both ART
and antibiotics for TB compared to when they only received ART up until about the
750th day. Between 2015 and 2019, the study also discovered geographical disparities
in the mortality rate for HIV-TB patients. The study also found that over a five-year
period, the frequency of TB and HIV mortality varied in the selected Counties. The
study discovered that ART and TB therapies, marital status, gender, WHO diagnostic
stage, age, weight, and institution of residence are the key factors influencing HIV-TB
patients' survival rates. Starting medicine later in the course of the medical condition
may have less of an effect on lowering TB/HIV than targeted therapies in the initial few
weeks and months after ART began. HIV-rationality. As a result, the use of ART and
TB treatments, as well as demographic variables and geographic determinants, each
have a statistically noteworthy impact on the life expectancy of HIV/TB infected as
well individuals. The study urges the MoH to give preference to the use underlying
ART and TB medication, the assessment of demographic traits, and spatial variables in
order to increase survival |
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