Application of Invariant Analyses to Study Survival Trends of Patients on Antiretroviral Therapy (ART) and TB Treatment in Kenya

Abstract

Kenya is one of the countries, globally, with a high burden of human immunodeficiency virus and tuberculosis. The co-infection between tuberculosis and human immunodeficiency virus/acquired immunodeficiency syndrome makes the management of the infection more complicated and reduces the chances of survival. The current study evaluates the trends in the survival of individuals with ART and TB management, especially in relation to various Counties in the country. The specific objective was to establish the survival trends of patients on Antiretroviral Therapy (ART) and TB treatment in Kenya using Kaplan Meier function. The study used a retrospective cohort study design. The target population included patients on co-therapy TB and ART management who attended the health facilities between 1st January 2015 and 31st December 2019. The sample of the study was obtained from all the available HIV-TB co-infected patients’ records in National AIDS & STIs Control Program (NASCOP) database (secondary data) from the selected counties in Kenya. Kaplan Meier estimator was used in the estimation of the survival function. Analysis was done using STATA v14.2 and Bayes’ v3.0.2. The study also found that HIV-TB patients’ death rates for the period between 2015 and 2019 varied from one County to another. The study also established that the distribution of TB and HIV deaths in the 47 Counties varied across the five years. In the year 2015, the total number of TB and HIV deaths in the 47 Countries was 1077, which decreased to 921 TB and HIV deaths in 2016 before decreasing to 391 in 2017, 106 in 2018 and 60 in 2019. The study found that the main factors significantly influencing HIV-TB confections include gender, marital status, WHO clinical stage, age, weight and facility levels.