HIV/AIDS treatment failure and associated factors in Ethiopia: meta-analysis

Endalamaw, Aklilu; Mekonnen, Mengistu; Geremew, Demeke; Yehualashet, Fikadu Ambaw; Tesera, Hiwot

doi:10.1186/s12889-020-8160-8

Cited by 42 publications

(66 citation statements)

References 38 publications

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“…Even though previous study findings revealed that adherence to first-line ART regimen is a protective factor to first-line ART treatment failure [ 18 , 21 , 24 , 25 ], the current study found no statistically significant association between first-line ART adherence and first-line ART treatment failure. This might be due to variation in sample size or research design.…”

Section: Discussioncontrasting

confidence: 99%

“…This study pointed out that the overall First-line ART treatment failure is 33.42% (95%CI 20.12, 42) in the study area. This finding is higher than the studies done in India (7.69%), a meta-analysis done in Ethiopia (15.9%) [ 17 , 18 ]. The discrepancy in this magnitude might be due to the differences in living conditions of the population, sample size difference, difference in study design and year of the study.…”

Section: Discussioncontrasting

confidence: 60%

“…Regarding factors associated with first line ART treatment failure in the present study, patients who had no opportunistic infections had a 64% lower likelihood of developing Firstline ART treatment failure as compared to their counterparts. This finding is supported by evidence from India, Western Oromia, Arbaminch, and Ethiopian meta-analysis [17][18][19][20]. Not only had the base-line opportunistic infections the finding also showed that the occurrence of opportunistic infection after ART initiation is associated with first line ART Treatment failure.…”

Section: Plos Onesupporting

confidence: 58%

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Magnitude of first line antiretroviral therapy treatment failure and associated factors among adult patients on ART in South West Shoa, Central Ethiopia

et al. 2020

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Background First-line antiretroviral treatment failure has become a public health concern in high, low and middle-income countries with high mortality and morbidity In Ethiopia, around 710,000 peoples were living with HIV and 420,000 of them were receiving ART in 2017. Little is known about the magnitude of first-line ART treatment failure and its associated factors in Ethiopia, particularly in the study area. Therefore, this study was aimed to find the magnitude of first-line ART treatment failure and its associated factors among adult patients attending ART clinic at Southwest shoa zone public hospitals. Methods Institutions based cross-sectional study was employed from February 1 to April 2, 2019. An interviewer administered questionnaire was used to collect data from 350 adult patients on ART using a systematic random sampling technique. The collected data were coded and entered into Epidata version 3 and exported to STATA SE version 14 for analysis. Bivariable and multivariable logistic regression was done to identify factors associated with first-line ART treatment failure. At 95% confidence level strength of association was measured using Odds ratio. Variables with a p-value of ≤ 0.25 in the bivariable analysis were considered as a candidate variable for multivariable analysis. To get the final variables step-wise backward selection procedure was used and those in the final model were selected at a p-value <0.05. Finally, texts, simple frequency tables, and figures were used to present the findings. Results In this study the magnitude of first-line ART treatment failure was 33.42%. Absence of baseline opportunistic infection AOR = 0.362 (95%CI0.178, 0.735), Staying on first-line ART for <5 years AOR = 0.47 (95%CI 0.252, 0.878), Nevirapine containing ART regimen AOR = 3.07 (95%CI 1.677, 5.63), Baseline CD4 count ≥100 cells/mm3 AOR = 0.299 (95%CI 0.152 0.591), absence of opportunistic infections after ART initiation AOR = 0.257 (95%CI 0.142, .467), time taking greater than an one-hour to reach health facility AOR 1.85 (95%CI 1.022 3.367) were significantly associated with first-line ART treatment failure. Conclusion The magnitude of first-line ART treatment failure was high in the study area. Base-line opportunistic infection, duration on first-line ART, NVP based ART, Baseline CD4 count level, OI after ART initiation, and time it takes to reach health facility were independent determinants of first-line ART treatment failure.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussioncontrasting

confidence: 60%

Section: Plos Onesupporting

confidence: 58%

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Magnitude of first line antiretroviral therapy treatment failure and associated factors among adult patients on ART in South West Shoa, Central Ethiopia

et al. 2020

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“…World Health Organization (WHO) clinical stage III/IV, opportunistic infections, low CD4 cell count, and poor adherence to ART were the identified associated factors for treatment failure. 13 …”

Section: Introductionmentioning

confidence: 99%

Antiretroviral Treatment Failure and Associated Factors Among HIV-Infected Children on Antiretroviral Therapy: A Retrospective Study

Getawa¹,

Fentahun²,

Adane³

et al. 2021

HIV

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Background HIV/AIDS-associated morbidity and mortality have reduced since the introduction of antiretroviral therapy (ART). Treatment failure is one of the causes of mortality, morbidity, and the development of drug-resistant viral strains. Therefore, this research aims to assess the prevalence and associated factors of treatment failure among children with HIV/AIDS on antiretroviral therapy attending the University of Gondar Specialized Referral Hospital, Northwest Ethiopia. Methods A retrospective study was conducted on 200 children registered for ART from 2005 to 2017. Data regarding patients’ socio-demographic, baseline clinical characteristics, and treatment-related information were collected through a review of their medical records. Data were entered into Epi-info version 3.5.3 and analyzed using statistical package for social sciences (SPSS) version 21 software. To summarize characteristics of the study participant’s descriptive statistics were done. Bivariable and multivariable binary logistic regression were fitted to identify factors associated with treatment failure. The odds ratio and 95% confidence interval (CI) were calculated to assess the strength of the association and P-value<0.05 in the multivariable regression was considered as statistically significant. Results The prevalence of ART failure was 12.5% (95% CI: 7.88, 17.12), clinical failure was the most common followed by immunologic failure with only a small proportion having both clinical and immunologic failure. The mean time to develop treatment failure after initiation of the first-line regimen was 22.28 ± 24.00 months. Being male (AOR= 3.15; 95% CI: 1.18–8.39), co-infected with tuberculosis (TB) at baseline (AOR= 2.37; 95% CI: 1.23–8.84), being on ART for a long period (>36 months) (AOR= 1.01; 95% CI: 1.34–2.89), and regimen change (AOR=9.22; 95% CI: 3.36–25.03) were factors of ART failure. Conclusion In this study, there is significant treatment failure among HIV-infected children. Having co-infection, being on ART for a long period, regimen change, and being male were found to be independent factors of treatment failure in children. Therefore, timely identification and monitoring of ART failure should be necessary to enhance the benefit and to prevent further complications. Prophylaxis for opportunistic infections such as co-trimoxazole preventive therapy should continue to recover the immunological status of the child.

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“…According to USAID report in Ethiopia, 690,000 people were living with HIV in 2018; 65% of people living with HIV were on ART in the same year [ 19 ]. AIDS estimated deaths in Ethiopia were reported at 11000 in 2018 [ 20 ]. In Ethiopia, only about a quarter of adolescents had comprehensive HIV knowledge [ 21 ].…”

Section: Introductionmentioning

confidence: 99%

Residence and young women’s comprehensive HIV knowledge in Ethiopia

et al. 2020

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Background Human immunodeficiency virus (HIV) infection is a global health problem. The epidemic is very serious in sub-Saharan Africa with approximately 70% of the global cases. The disease particularly affects youth, accounting for half of the new HIV infections yearly. Inadequate knowledge may contribute to the high rates among youth. Hence, the main aim of this study was to examine the association between residence and comprehensive HIV knowledge among women aged 15–24 years in Ethiopia. Methods This cross-sectional study used nationally representative data from the 2016 Ethiopian demographic health survey (n = 5926). Chi-square tests and multivariable logistic regression modeling were performed. Results Approximately 23.9% of the study participants had a comprehensive HIV knowledge and 74.7% were rural residents. In the multivariable-adjusted model, we found a significant interaction between place of residence and HIV testing on comprehensive HIV knowledge (P for interaction = 0.005). In the subgroup analysis, a statistically significant associations between place of residence and comprehensive HIV knowledge was found only in women who have never been tested for HIV. In this subgroup, rural women had lower odds of having a comprehensive HIV knowledge compared to their urban counterparts (OR 0.42, 95% CI: 0.23–0.74; P = 0.003). Furthermore, in the subgroup of women who have never been tested for HIV, education and region were significantly associated with comprehensive HIV knowledge. Compared to women with no education, the odds of having a comprehensive HIV knowledge were higher in women who had primary (OR 2.86, 95% CI: 1.63–5.02; P < 0.001) and secondary or above education (OR 5.49, 95% CI: 2.92–10.32; P < 0.001), respectively. The odds of having a comprehensive HIV knowledge were lower in women from the Somali region compared to women from Addis Ababa region (OR 0.41, 95% CI: 0.18–0.90; P = 0.027). Conclusions Rural residence was negatively associated with comprehensive HIV knowledge only in women who have never been tested for HIV. These findings suggest that the development and implementation HIV education and awareness programs should target rural areas, especially where there is limited access to HIV testing.

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HIV/AIDS treatment failure and associated factors in Ethiopia: meta-analysis

Cited by 42 publications

References 38 publications

Magnitude of first line antiretroviral therapy treatment failure and associated factors among adult patients on ART in South West Shoa, Central Ethiopia

Magnitude of first line antiretroviral therapy treatment failure and associated factors among adult patients on ART in South West Shoa, Central Ethiopia

Antiretroviral Treatment Failure and Associated Factors Among HIV-Infected Children on Antiretroviral Therapy: A Retrospective Study

Residence and young women’s comprehensive HIV knowledge in Ethiopia

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