Table 3.
Factors Associated With Mortality in KIULARCO Participants Under 4 Different Methods of Mortality Estimationa, Ifakara, Tanzania, 2005–2015
| Participant Characteristic | Method A: Data as Captured in Database | Method B: Incorporating Tracing Outcomes | Method C: Frangakis and Rubin ( 14 ) Approach | Method D: Extension to Frangakis and Rubin ( 14 ) Approach | ||||
|---|---|---|---|---|---|---|---|---|
| HR | 95% CI | HR | 95% CI | HR | 95% CI | HR | 95% CI | |
| Baseline Covariates | ||||||||
| Year of enrollment | ||||||||
| 2005–2007 | 0.94 | 0.67, 1.32 | 0.87 | 0.63, 1.21 | 0.58 | 0.37, 0.91 | 0.62 | 0.39, 1.00 |
| 2008–2009 | 1.00 | Referent | 1.00 | Referent | 1.00 | Referent | 1.00 | Referent |
| 2010–2012 | 0.69 | 0.51, 0.92 | 0.98 | 0.76, 1.26 | 1.86 | 1.32, 2.62 | 1.84 | 1.30, 2.63 |
| 2013–2015 | 0.37 | 0.23, 0.59 | 0.52 | 0.34, 0.80 | 1.18 | 0.55, 2.50 | 1.17 | 0.59, 2.33 |
| Sex | ||||||||
| Male | 1.24 | 1.03, 1.50 | 1.29 | 1.08, 1.53 | 1.32 | 1.00, 1.73 | 1.38 | 1.05, 1.80 |
| Female | 1.00 | Referent | 1.00 | Referent | 1.00 | Referent | 1.00 | Referent |
| Age, years | ||||||||
| 15–24 | 1.05 | 0.72, 1.53 | 0.92 | 0.64, 1.33 | 0.56 | 0.31, 0.99 | 0.56 | 0.32, 0.99 |
| 25–34 | 0.85 | 0.69, 1.05 | 0.88 | 0.73, 1.07 | 0.85 | 0.62, 1.15 | 0.86 | 0.63, 1.18 |
| 35–44 | 1.00 | Referent | 1.00 | Referent | 1.00 | Referent | 1.00 | Referent |
| ≥45 | 1.09 | 0.89, 1.34 | 1.12 | 0.93, 1.35 | 1.01 | 0.75, 1.36 | 0.98 | 0.73, 1.30 |
| Marital status | ||||||||
| Married/cohabiting | 1.00 | Referent | 1.00 | Referent | 1.00 | Referent | 1.00 | Referent |
| Never married | 1.08 | 0.86, 1.35 | 1.03 | 0.84, 1.28 | 1.04 | 0.73, 1.47 | 0.99 | 0.70, 1.40 |
| Separated/divorced | 0.89 | 0.68, 1.16 | 0.92 | 0.72, 1.16 | 0.96 | 0.66, 1.39 | 1.00 | 0.69, 1.45 |
| Widowed/other | 0.88 | 0.66, 1.18 | 0.86 | 0.65, 1.13 | 0.82 | 0.50, 1.35 | 0.82 | 0.50, 1.36 |
| HIV status of partner | ||||||||
| Positive | 1.00 | Referent | 1.00 | Referent | 1.00 | Referent | 1.00 | Referent |
| Negative | 1.29 | 0.82, 2.05 | 1.21 | 0.79, 1.85 | 1.08 | 0.55, 2.12 | 1.07 | 0.55, 2.10 |
| Unknown | 1.22 | 0.86, 1.74 | 1.35 | 0.98, 1.87 | 1.41 | 0.86, 2.31 | 1.45 | 0.87, 2.40 |
| Not applicable | 1.85 | 0.99, 3.46 | 1.95 | 1.08, 3.52 | 2.39 | 0.89, 6.41 | 2.01 | 0.78, 5.18 |
| Disclosure of HIV status | ||||||||
| No | 1.00 | Referent | 1.00 | Referent | 1.00 | Referent | 1.00 | Referent |
| Yes | 1.34 | 1.06, 1.69 | 1.28 | 1.03, 1.59 | 1.03 | 0.77, 1.38 | 1.04 | 0.76, 1.42 |
| Referral to clinic as hospital inpatient | ||||||||
| No | 1.00 | Referent | 1.00 | Referent | 1.00 | Referent | 1.00 | Referent |
| Yes | 1.49 | 0.99, 2.25 | 1.45 | 1.00, 2.11 | 1.76 | 1.09, 2.83 | 1.69 | 1.02, 2.80 |
| Distance of ward of residence from clinic, km | ||||||||
| 1 | 1.00 | Referent | 1.00 | Referent | 1.00 | Referent | 1.00 | Referent |
| 2–49 | 0.62 | 0.46, 0.84 | 0.61 | 0.46, 0.81 | 0.64 | 0.41, 1.00 | 0.66 | 0.42, 1.04 |
| 50–79 | 0.91 | 0.69, 1.18 | 0.80 | 0.62, 1.04 | 0.51 | 0.31, 0.86 | 0.53 | 0.33, 0.84 |
| ≥80 | 0.64 | 0.48, 0.84 | 0.65 | 0.50, 0.85 | 0.79 | 0.52, 1.18 | 0.75 | 0.49, 1.15 |
| Smoking status | ||||||||
| Never/former smoker | 1.00 | Referent | 1.00 | Referent | 1.00 | Referent | 1.00 | Referent |
| Current smoker | 1.22 | 0.92, 1.61 | 1.23 | 0.94, 1.61 | 1.44 | 0.99, 2.08 | 1.39 | 0.95, 2.02 |
| Pregnant | ||||||||
| No | 1.00 | Referent | 1.00 | Referent | 1.00 | Referent | 1.00 | Referent |
| Yes | 0.99 | 0.49, 2.03 | 1.26 | 0.71, 2.19 | 0.95 | 0.34, 2.59 | 1.11 | 0.41, 2.98 |
| Body mass indexb | ||||||||
| Underweight (<18.5) | 1.51 | 1.16, 1.98 | 1.56 | 1.22, 2.00 | 1.60 | 1.17, 2.20 | 1.58 | 1.15, 2.17 |
| Normal-weight (18.5–24.9) | 1.00 | Referent | 1.00 | Referent | 1.00 | Referent | 1.00 | Referent |
| Overweight (25.0–29.9) | 0.66 | 0.41, 1.07 | 0.63 | 0.40, 1.00 | 0.66 | 0.32, 1.35 | 0.73 | 0.34, 1.56 |
| Obese (≥30.0) | 0.44 | 0.14, 1.36 | 0.32 | 0.11, 0.94 | 0.16 | 0.03, 0.81 | 0.15 | 0.03, 0.84 |
| WHO HIV clinical stage | ||||||||
| 1 | 1.00 | Referent | 1.00 | Referent | 1.00 | Referent | 1.00 | Referent |
| 2 | 1.44 | 1.08, 1.94 | 1.45 | 1.12, 1.89 | 1.52 | 1.05, 2.20 | 1.39 | 0.95, 2.02 |
| 3 | 1.90 | 1.46, 2.49 | 2.10 | 1.65, 2.68 | 2.43 | 1.69, 3.48 | 2.32 | 1.62, 3.32 |
| 4 | 3.31 | 2.47, 4.44 | 3.43 | 2.60, 4.53 | 3.16 | 2.01, 4.99 | 3.01 | 1.90, 4.77 |
| CD4 cell count, cells/mm3 | ||||||||
| <100 | 1.00 | Referent | 1.00 | Referent | 1.00 | Referent | 1.00 | Referent |
| 100–199 | 0.73 | 0.54, 0.97 | 0.73 | 0.55, 0.96 | 0.67 | 0.42, 1.07 | 0.65 | 0.41, 1.04 |
| 200–349 | 0.57 | 0.41, 0.79 | 0.59 | 0.45, 0.78 | 0.59 | 0.39, 0.90 | 0.58 | 0.39, 0.87 |
| ≥350 | 0.32 | 0.22, 0.46 | 0.33 | 0.23, 0.47 | 0.25 | 0.15, 0.43 | 0.24 | 0.14, 0.43 |
| Tuberculosis | ||||||||
| No | 1.00 | Referent | 1.00 | Referent | 1.00 | Referent | 1.00 | Referent |
| Yes | 1.00 | 0.75, 1.33 | 0.90 | 0.69, 1.18 | 0.75 | 0.48, 1.19 | 0.71 | 0.46, 1.10 |
| Time-Dependent Covariates | ||||||||
| Time since ART initiation during follow-up, months | ||||||||
| Not yet initiated | 1.00 | Referent | 1.00 | Referent | 1.00 | Referent | 1.00 | Referent |
| 0.1–5.9 | 0.23 | 0.18, 0.29 | 0.34 | 0.27, 0.42 | 0.63 | 0.47, 0.86 | 0.6 | 0.43, 0.84 |
| 6–11.9 | 0.04 | 0.02, 0.05 | 0.06 | 0.04, 0.08 | 0.16 | 0.10, 0.26 | 0.13 | 0.08, 0.22 |
| ≥12 | 0.03 | 0.02, 0.05 | 0.03 | 0.02, 0.04 | 0.02 | 0.01, 0.03 | 0.01 | 0.01, 0.02 |
| No. of gaps in care (periods of LTFU) | ||||||||
| 0 | 1.00 | Referent | 1.00 | Referent | 1.00 | Referent | 1.00 | Referent |
| 1 | 0.17 | 0.13, 0.21 | 0.35 | 0.29, 0.43 | 2.30 | 1.72, 3.06 | 1.95 | 1.46, 2.61 |
| 2 | 0.18 | 0.11, 0.28 | 0.24 | 0.17, 0.36 | 0.71 | 0.36, 1.39 | 0.71 | 0.37, 1.37 |
| ≥3 | 0.17 | 0.08, 0.35 | 0.27 | 0.16, 0.46 | 1.27 | 0.58, 2.78 | 0.98 | 0.42, 2.28 |
Abbreviations: ART, antiretroviral therapy; CI, confidence interval; HIV, human immunodeficiency virus; HR, hazard ratio; KIULARCO, Kilombero and Ulanga Antiretroviral Cohort; LTFU, lost to follow-up; WHO, World Health Organization.
a Results were derived from multivariable Cox proportional hazards models adjusting for all variables shown in the table, with multiple imputation for missing baseline covariates (see Methods section of text for details).
b Weight (kg)/height (m)2.