<p>A total of 29982 study participants were randomly selected from each program year (2018-2020) making a total of 89946 participants for this study. The annual specific mortality was found to be 5.9%, 4.3%, and 3.14% in 2018, 2019, and 2020 respectively. Mortality was significantly associated with malnutrition AOR= 2.1 (95% CI 1.4 – 3.1), Being a male AOR=2.0 (95% CI: 1.6-3.9) participants with active TB or history of TB treatment AOR= 1.7 (95% CI: 1.4-6.6), WHO clinical stage (3) AOR=2.2 (1.5-3.3), WHO clinical stage (4) AOR=7.3 (3.9-13.7) and CD4 count less than 200cells/mil AOR=1.7(95% CI: 1.31-2.3).</p>