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Bayesian Survival Analysis of Adult Tuberculosis Patients at Lemlem Karl Hospital, Maichew, Southern Tigray, Ethiopia
Lemlem Tekle Berhe
Abrha Haftu Teklu
Lewtnesh Berihun Dangew
Netsanet Berhe Gidey
Abstract
Tuberculosis (TB) continues to be a significant issue on the agenda of the Southern Tigray population, and worldwide evidence regarding clinical and demographic factors affecting the survival of adult TB patients at the research site is lacking, which restricts the ability to provide evidence-based patient care and risk-stratified follow-up at the health-facility level. Thus, this research was performed in order to determine the factors that influence the survival of adult patients with tuberculosis who are treated at the Lemlem Karl Hospital Medical Center. It was a retrospective cohort study of 242 adult TB patients who registered between July 2020 and January 2024. Survival functions were compared using Kaplan-Meier curves and log-rank tests, and Bayesian survival models were fitted to determine the predictors of survival time. Out of the participants in the study, 178 (73.6) were censored, and the median survival was 26 months. The Bayesian log-normal accelerated failure time (AFT) model was the most suitable in light of the information. The variables that were significant predictors of the survival time were age, place of residence, baseline body weight, HIV status, BMI, anti-TB drug dose level, and cigarette smoking. Age (31-45, 46-60 and ≥61 years old), rural status, HIV positivity, high doses (III and IV), overweight and obesity, and cigarette smoking were factors that decreased the survival time of adult TB patients. Finally, the Bayesian log-normalized AFT model was found to be effective in explaining adult TB survival in this context and defining the major high-risk patient populations, and showed that clinical follow-up, combination of TB and HIV-based care, routine nutritional assessment, and specific tracking of older, rural, and clinically severe TB patients in Lemlem Karl Hospital were the priorities that needed to be reinforced.
