Loss to Follow-up and its Predictors Among Adult HIV Patients on Rapid Initiation of Antiretroviral Treatment in Selected Governmental Hospitals, Southwest Ethiopia, 2019
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Date
2019-06
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Addis Ababa University
Abstract
Background: Currently, lifelong anti-retroviral treatment were given for people living withHIV without considering their CD4 cell counts & WHO clinical staging in most countries of the World including Ethiopia. Even if there were no sufficient evidence on loss to follow up after the implementation of rapid initiation of anti retroviral treatment in Ethiopia, studies showed that rapid initiation of ART will increase the risk of loss to follow up especially in low
level income countries.
Objective: The aim of this study was to assess loss to follow up and its predictors among adult HIV infected patients on rapid initiation of anti retroviral treatment in Gebretsadik Shawo General Hospital and Mizan-Tepi University Teaching Hospital.
Methods: Retrospective cohort study design was used to assess loss to follow up and its predictors among adult HIV infected patients on rapid initiation of anti retroviral treatment in Gebretsadik Shawo General Hospital and Mizan-Tepi University Teaching Hospital fromOctober 2017 to December 31, 2018. A total of 318 patients card were retrieved by using checklists developed to assess loss to follow up from anti retroviral therapy clinics. Data were
collected from March 20 through April 15, 2019, entered into Epi data 3.1 and exported to statistical package for social sciences (SPSS) version 24. Kaplan–Meier curve and log-rank test were used to compare survival experiences. Cox-regression was used to identify the predictors of loss to follow up at p≤ 0.05.
Result: All the 318 patients were followed for 2662 person-months and the overall incidence rate of loss to follow up were 3.5 per 100 person months (95% CI: 2.8, 4.2). Being male sex (AHR =4.33; 95%CI: 2.22, 8.43), unknown IPT status (AHR=5.49; 95%CI: 1.46, 20.59), not received IPT
history (AHR=2.42; 95% CI: 1.49, 3.91), bedridden functional status (AHR=5.049; 95% CI:2.34, 10.87) and non disclosures (AHR=2.28; 95% CI: 1.35, 3.83) were identified asindependent predictors of time to LTFU.
Conclusion: high proportion of loss to follow up was recorded especially on the same day treatment. Therefore, proper counseling and tracing mechanisms were recommended for highly risky patients for loss to follow up.
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Keywords
Rapid initiation of ART, Loss to follow up, Southwest Ethiopia.