2014.ISDS.Abstracts.Final.pdf ISDS Annual Conference Proceedings 2014. This is an Open Access article distributed under the terms of the Creative Commons Attribution- Noncommercial 3.0 Unported License (http://creativecommons.org/licenses/by-nc/3.0/), permitting all non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. ISDS 2014 Conference Abstracts Pre-ART Mortality and its Determinants in a Tanzania Public Driven HIV Care Program Bonita K. Kilama* Epidemiology unit, Tanzania National AIDS Control Program, Dar es Salaam, United Republic of Tanzania Objective The aim of this write up was to assess the level of mortality and its determinants among HIV infected adults prior to ART initiation. Introduction Limited information is available on mortality experience of HIV infected patients prior to the start of antiretroviral therapy (ART), as monitoring of HIV care services has mainly focused on ART initiation and subsequent patient survival. By 2013, Tanzania 1,209 health facilities with HIV services, and 800,000 patients accessing ART Methods A retrospective cohort study of 526,059 HIV infected adults ( 15 years) enrolled in care prior to ART initiation from November 2004 to December 2011 in 348 health facilities was conducted. The data was used to analyze mortality and its determinants in pre-ART phase, TB events and CD4 testing. Results Sixty seven percent of patients were female. Among the enrolled 429,476 patients had follow-up data and 10,362 deaths. The majority (85%) had working status, 82% - CD4 count test done in three months and 91% were screened for TB at first visit. Of the 7.2 million visits 93% had TB screening documented and of 397,288 CD4 tests done in the pre ART phase 71% (282,936 tests) were done in the first month. The overall mortality rate was 37.6 deaths per 1000 person years (95% CI 36.9 - 38.3). Independent predictors of pre-ART mortality were: WHO stage 3 (AHR=2.37; 95% CI 1.94-2.90), WHO Stage 4 (AHR=4.53; 95% CI 3.64-5.64), female sex (AHR=0.62; 95% CI 0.56 -0.70), CD4 count 200 (AHR=0.17; 95% CI 0.15-0.20) and weighing more than 45kg at CTC enrolment (AHR=0.53; 95% CI 0.46-0.62) was significantly associated with a lower hazard of death. Conclusions Routinely collected data suggest high mortality among patients in the pre-ART phase especially among those with low CD4 counts, TB confirmed, and WHO stage 3 and 4. From findings TB screening and CD tests are largely done as per national guidelines. There is need to establish effective interventions targeting patients in the pre ART phase for patient and program improvement Keywords Pre-ART; Mortality; Adults Acknowledgments 1. Dr Candida Moshiro - Biostatistician with Muhimbili University of Health and Allied Sciences for supervising my masters dissertation tirelessly. 2.Jim Todd - Reader at London School of Hygiene and Tropical Medicine for spearheading the various analysis work we do as an institution as well as masters students like myself References 1. Burtle D, Welfare W, Elden S, et al. Introduction and evaluation of a “pre-ART care” service in Swaziland: an operational research study. BMJ Open. 2012;2(2):e000195. 2. Palombi L, Marazzi MC, Guidotti G, et al. Incidence and Predictors of Death, Retention, and Switch to SecondLine Regimens in AntiretroviralTreated Patients in SubSaharan African Sites with Comprehensive Monitoring Availability. Clin. Infect. Dis. 2009;48(1):115–122. 3. Geng EH, Bwana MB, Muyindike W, Glidden D V, Bangsberg DR, Neilands TB, et al. Failure to Initiate Antiretroviral Therapy, Loss to Follow-up and Mortality Among HIV-Infected Patients During the Pre-ART Period in Uganda. 2013;63(2):64–71. *Bonita K. Kilama E-mail: bonitakilama@yahoo.com Online Journal of Public Health Informatics * ISSN 1947-2579 * http://ojphi.org * (1):e137, 201