Auditing HIV-Related Deaths Using the Three-Delay Framework: Evidence from Lubumbashi, in Democratic Republic of Congo
Mbayo Lukasu Xavier *
AMAVM, NGO, L, Lubumbashi, DR Congo.
Kabamba Temple
AMAVM, NGO, L, Lubumbashi, DR Congo.
Kadiebwue Mulumba
Department of Internal Medicine, University of Lubumbashi, DR Congo.
Kasonga Kasonga
Department of Gynecology and Obstetrics, University of Kamina, DR Congo.
Nduaya Ngalamulume
Kasai Provincial Health Division, Public Health Sector, DR Congo.
Kabeya Mulembe
Department of Internal Medicine, University of Kananga, DR Congo.
Tunsele Kasonga
Kasai Provincial Health Division, Public Health Sector, DR Congo.
Muanangoyi Crispin
Kasai Provincial Health Division, Public Health Sector, DR Congo.
Kitolo Safi
Diabetes Center, Lubumbashi, Private Health Sector, DR Congo.
Tshoto Kabilu
Kasai Provincial Health Division, Public Health Sector, DR Congo.
Abel Nkongolo
Kasai Provincial Health Division, Public Health Sector, DR Congo.
Mukendi Richard
Department of Gynecology and Obstetrics, University of Lubumbashi, DR Congo.
*Author to whom correspondence should be addressed.
Abstract
Background: HIV-related mortality remains high in sub-Saharan Africa despite expanded access to antiretroviral therapy. This study aimed to audit HIV-related deaths using the three-delay model and assess its impact on achieving UNAIDS “95-95-95” and WHO mortality targets.
Methods: We conducted a retrospective descriptive audit of 159 hospitalized adults living with HIV at Jason Sendwe Provincial Hospital, Lubumbashi, from January to December 2024. Data were analyzed to identify delays in care and their association with mortality.
Results: In-hospital mortality was 33.3%. The first delay (care-seeking) and third delay (treatment interruption and unsuppressed viral load) were strongly associated with death (PR = 6.8 and PR = 5.5, respectively). Over half of the deceased patients had unsuppressed viral load, and 22.5% had interrupted ART, undermining UNAIDS targets.
Conclusion: Addressing delays in care, particularly treatment continuity, is essential to reducing HIV-related mortality and achieving global targets in resource-limited settings.
Keywords: HIV/AIDS, mortality inpatient, hospitalization, three delays model