Factors affecting time to remission of Kaposi's Sarcoma patients in Uganda

Abstract

ABSTRACT The objective of this study was to investigate the factors associated with Time to Remission of Kaposi’s sarcoma. The assessment was made by socio-demographic characteristics of patients, clinical conditions of patients and type of treatment administered. Administrative records of 354 patients admitted to the Uganda Cancer Institute, Mulago Hospital, between 2010 and 2017 were used in the assessment. The analysis was done using a time-to-event analysis using Kaplan Meier Survival functions and Accelerated Failure Time model. In the results, the median Remission time of patients who had attained remission by the time of the study (N = 170) was 104 weeks (range, 1-344) after admission. In the multiple regression analysis – using the weibull regression –significant variation in remission time of patients were noted by sex of patient, residential status, type of tumor, Cytopenias, Viral load, CD4 count and treatment received (p < 0.05). Particularly, remission time was shorter among the male than females, those whose CD4 count was low had a longer time to remission compared to those with higher CD4 count. In conclusion, the determinants of remission time of patients with Kaposi’s sarcoma in Uganda are place of residence of patient, sex of patient, type of Cytopenias, type of tumor, viral load copies at admission and CD4 count of the patient at admission and treatment. The study recommended three major aspects to help in accelerating time to remission of patients with Kaposi’s sarcoma: i. Mechanism put in place to enhance routine screening for underlying health conditions for Kaposi’s sarcoma patients ii. The need for a routine checkup for viral load and CD4 as it was revealed that patients with better viral load and CD4 counter had shorter time to remission. iii. Set-up treatment centres for cancer medication in the whole country.