Incidence and predictors of lost to follow up among children on antiretiroviral therapy at east and west Gojjam zone referral hospitals, amhara regional state, 2018: a retrospective cohort study
| dc.contributor.advisor | Gebremichael, Bereket (BSc, MSc) | |
| dc.contributor.author | Fetene, Tamene | |
| dc.date.accessioned | 2018-12-04T07:27:49Z | |
| dc.date.accessioned | 2023-11-05T09:33:53Z | |
| dc.date.available | 2018-12-04T07:27:49Z | |
| dc.date.available | 2023-11-05T09:33:53Z | |
| dc.date.issued | 2018-06 | |
| dc.description.abstract | Background: Globally, 36.7 million people were living with HIV up to midd-2017 of which 2.1 million were children less than 15 years. Antiretroviral therapy is introduced to maintain maximal suppression of viral replication, to restore immune function, to reduce HIV-related morbidity and mortality and to prolong survival. However, effectiveness of highly active ART could vary from region to region because of the difference in the retention of patients on antiretroviral therapy. Objectives: The main aim of the study is to asses incidence and predictors of lost to follow up among children on antiretroviral therapy at East and West Gojjam Zone referral hospitals, 2018. Methods: Six years of retrospective follow up study was conducted among 561 children aged less than or equal to 14 years who were newly enrolled in HIV care clinic from 1st of January 2012 to December 31, 2017 after gating ethical clearance from institutional review board of Addis Ababa University. Data was entered into and cleared using Epi-Data version 3.1 and then was exported to STATA version 14 for further statistical analysis. Kaplan Meier survival curve was used to estimate the cumulative survival time and Log rank test was used to compare the survival time between different categories of the explanatory variables. Multivariable Cox proportional hazards model was fitted to identify predictors of lost to follow up (LTFU). Results: Out of the 561 charts reviewed, 533 children records were included in the final analysis. A total of 46 new LTFU cases were observed during the 15288 Person months follow up period. Hence, the overall incidence rate of LTFU was 3.6 per 100 person years. Baseline age <1 year (AHR; 3.7, 95% CI: 1.08, 12.68), and 1-5 years (AHR:3.86, 95% CI:1.73,8.61),OIs at baseline (AHR:2.26,95%CI:(1.08,4.71),hemoglobin level<10gm/dl(AHR:3.57,95% CI:1.54,8.24),baseline malnutrition in the form of underweight(weight for age Z score (WAZ)<-2)(AHR:5.67,95%CI :2.11,15.21)were independent predictors of LTFU occurrence. Conclusion and Recommendation: The first 18th months of ART initiation is the time of high LTFU .Baseline age <1 year and 1-5 years, WAZ<-2, OIs at baseline, not taking cotrimoxazole preventive therapy and Hgb <10gm/dl were an independent predictor of LTFU. Hence, Special emphasis and close follow up should be given to patients in the first 18th months of ART initiation and to those children having the above predictors. | en_US |
| dc.identifier.uri | http://etd.aau.edu.et/handle/123456789/14791 | |
| dc.language.iso | en_US | en_US |
| dc.publisher | Addis Ababa University | en_US |
| dc.subject | Addis Ababa, ART, Ethiopia, Incidence rate, lost to follow up, | en_US |
| dc.title | Incidence and predictors of lost to follow up among children on antiretiroviral therapy at east and west Gojjam zone referral hospitals, amhara regional state, 2018: a retrospective cohort study | en_US |
| dc.type | Thesis | en_US |