CD4 and immune system disorder: This finding is also in line with other studies conducted in other sub-Saharan Africa countries which showed that most of the deaths occurred in the first 6 months following ART initiation [28, 29].This high early mortality after ART initiation in our study area might be attributed to the proportion (70%) of the patients having CD4 counts or percentages below the threshold for severe immunodeficiency at the time of ART initiation.