Incidence and predictors of loss to follow-up among human immunodeficiency virus-infected adult patients on anti-retroviral therapy at Hadiya zone public hospitals, southern Ethiopia: a retrospective cohort study

Bikoro, Belachew; Oljira, Lemessa; Gobena, Tesfaye; Erkalo, Desta

doi:10.1007/s10389-020-01268-1

Cited by 7 publications

(13 citation statements)

References 25 publications

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“…On the other hand, the result of this study is inconsistent with studies conducted in South Africa and Kenya (34,37). The possible explanation might be patients with stage I and II not feel sick enough to accept restrictive medical care (47). Additionally, in South Africa children in this stage were asymptomatic and health care workers were not given more attention than those had advanced disease (34).…”

Section: Discussioncontrasting

confidence: 85%

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Incidence and Predictors of Lost to Follow up Among Children Attending ART Clinic at Dessie Referral Hospital, Northeast Ethiopia: A Retrospective Cohort Study

Menshaw¹,

Birhanu²,

A³

et al. 2020

Preprint

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Background: Despite, antiretroviral therapy could reduce the transmission of human immunodeficiency virus and related morbidity, loss to follow up is a main challenge among children living with human immunodeficiency virus. Therefore, the aim of this study was to assess the incidence and predictors of loss to follow up among under 15 years old children attending antiretroviral therapy clinic at Dessie referral hospital, North east Ethiopia.Methods: A ten-year institution based retrospective cohort study was employed among 448 under 15 years’ old children who were enrolled on antiretroviral therapy. Data were entered and cleared using Epi- data version 3.1 and then exported to STATA version 14 for further statistical analysis. Kaplan Meier survival curve was used to estimate the 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 loss to follow up and p-value < 0.05 was considered as statically significant.Results: The overall incidence rate of loss to follow up was 6.3 per100 children in years of observation. Being male (AHR=2.1, CI =1.37 ,3.34), age 1-5 years (AHR=1.6, CI=1.05,2.46), poor adherence to antiretroviral therapy (AHR = 6.6; CI=4.11,10.66), fair adherence to antiretroviral therapy (AHR= 2.2; CI = 1.13 ,4.20), regimen was not changed (AHR = 4.1; CI = 2.59 ,6.45), world health organization stage III and IV (AHR= 2.2; CI =1.40, 3.33) and height for age < -2 z score (AHR = 2.2; CI = 1.43, 3.44) were predictors of loss to follow up.Conclusion: The incidence rate of loss to follow was high. Age 1-5 years, world health organization stage III and IV, poor and fair adherence to antiretroviral therapy, regimen was not changed, being male and stunted were higher risk for loss to follow up. Therefore, close monitoring to the higher risk groups for loss to follow up highlighted in this study could decrease the rate of loss to follow up. Improving the adherence of children to antiretroviral therapy and nutritional support for stunted children were also recommended.

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Section: Discussioncontrasting

confidence: 85%

“…Furthermore, LTFU is a critical barrier for determining the clinical outcome in HIV treatment program and identifying modi able factors of LTFU is fundamental for designing effective patient retention strategy (47).…”

Section: Introductionmentioning

confidence: 99%

Incidence and Predictors of Lost to Follow up Among Children Attending ART Clinic at Dessie Referral Hospital, Northeast Ethiopia: A Retrospective Cohort Study

Menshaw¹,

Birhanu²,

A³

et al. 2020

Preprint

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“…34 , 37 The possible explanation might be that patients with stage I and II do not feel sick enough to accept restrictive medical care. 49 Additionally, in South Africa, children with this stage were asymptomatic, and health care workers might not give as much attention as to those with advanced disease. 34…”

Section: Discussionmentioning

confidence: 99%

Incidence and Predictors of Loss to Follow-Up Among Children Attending ART Clinics in Northeast Ethiopia: A Retrospective Cohort Study

Menshw

Birhanu²,

Gebremaryam³

et al. 2021

HIV

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Background It is known that antiretroviral therapy reduces the transmission of human immunodeficiency virus and AIDS-related morbidity. The coverage of HIV drugs is increasing to control further spread of HIV and children living with HIV are the target groups in using these medications. However, loss to follow-up remains a critical challenge among these groups of the population. The aim of this study was therefore to assess the incidence and predictors of loss to follow-up among children attending antiretroviral therapy clinics. Methods A ten-year institution-based retrospective cohort study was employed among 448 children enrolled in antiretroviral therapy. Data were entered and cleaned using EpiData version 3.1 and then exported to STATA version 14 for further statistical analysis. The Kaplan–Meier survival curve was used to estimate the survival time and the 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 loss to follow-up and p-value < 0.05 was considered statistically significant. Results The incidence rate of loss to follow-up was 6.3 per 100 children years of observation. Being male (AHR = 2.1, CI = 1.37, 3.34), aged 1–5 years (AHR = 1.6, CI = 1.05, 2.46), poor adherence to antiretroviral therapy (AHR = 6.6; CI = 4.11, 10.66), fair adherence to antiretroviral therapy (AHR = 2.2; CI = 1.13, 4.20), regimen was not changed (AHR = 4.1; CI = 2.59, 6.45), World Health Organization stage III and IV (AHR = 2.2; CI = 1.40, 3.33) and height for age <−2 z score (AHR = 2.2; CI = 1.43, 3.44) were predictors of loss to follow-up. Conclusion Nearly seven out of 100 HIV-infected children were lost to follow-up from their link to ART clinics within a one-year follow-up. Non-modifiable demographic characteristics, clinical stage and nutritional status, and ART-related variables were associated with children’s loss to follow-up. Therefore, close monitoring of the “at risk” groups might decrease the rate of loss to follow-up. Improving adherence to antiretroviral therapy and nutritional support are also recommended.

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“…Moreover, studies conducted in Ethiopia before UTT have shown that both the proportion and incidence of LTFU greatly vary across regions and health institutions. For instance, in Debre Markos, Gondar, Pawi, Hadiya, and Jigigia (Eastern Ethiopia), it reaches 10.5 per 100 PYO, 11.6 per 100 PYO, 11.9 per 100 PYO, and 26.6 per 100 PY, respectively (16)(17)(18)(19)(20). The above studies also showed that the incidence of LTFU increases exponentially over time.…”

Section: Introductionmentioning

confidence: 89%

Loss to follow-up in “test and treat era” and its predictors among HIV-positive adults receiving ART in Northwest Ethiopia: Institution-based cohort study

Bantie

Seid

Kerebeh

et al. 2022

Front. Public Health

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BackgroundPeople living with HIV/AIDS are enrolled in lifelong Anti-Retroviral Treatment (ART) irrespective of their clinical staging as well as CD4 cell count. Although this “Universal Test and Treat” strategy of ART was found to have numerous benefits, loss from follow-up and poor retention remained a long-term challenge for the achievement of ART program targets. Hence, this study is aimed at addressing the much-needed effect of the test and treat strategy on the incidence of loss to follow-up (LTFU) in Ethiopia.Method and materialsAn institution-based follow-up study was conducted on 513 adults (age ≥15) who enrolled in ART at a public health institution in Bahir Dar City, Northwest Ethiopia. Data were extracted from the charts of selected patients and exported to Stata 14.2 software for analysis. Basic socio-demographic, epidemiological, and clinical characteristics were described. The Kaplan–Meier curve was used to estimate the loss to follow-up free (survival) probability of HIV-positive adults at 6, 12, 24, and 48 months of ART therapy. We fitted a multivariable Cox model to determine the statistically significant predictors of LTFU.ResultThe incidence density of LTFU was 9.7 per 100 person-years of observation (95% CI: 7.9–11.9 per 100 PYO). Overall, LTFU is higher in the rapid ART initiation (24% in rapid initiated vs. 11.3% in lately initiated, AHR 2.08, P = 0.004), in males (23% males vs. 14.7% females, AHR1.96, P = 0.004), in singles (34% single vs. 11% married, with AHR1.83, P = 0.044), in non-disclosed HIV-status (33% non-disclosed 11% disclosed, AHR 2.00 p = 0.001). Patients with poor/fair ART adherence were also identified as another risk group of LTFU (37% in poor vs. 10.5% in good adherence group, AHR 4.35, P = 0.001).ConclusionThe incidence of LTFU in this universal test and treat era was high, and the highest figure was observed in the first 6 months. Immediate initiation of ART in a universal test and treat strategy shall be implemented cautiously to improve patient retention and due attention shall be given to those high-risk patients.

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Incidence and predictors of loss to follow-up among human immunodeficiency virus-infected adult patients on anti-retroviral therapy at Hadiya zone public hospitals, southern Ethiopia: a retrospective cohort study

Cited by 7 publications

References 25 publications

Incidence and Predictors of Lost to Follow up Among Children Attending ART Clinic at Dessie Referral Hospital, Northeast Ethiopia: A Retrospective Cohort Study

Incidence and Predictors of Lost to Follow up Among Children Attending ART Clinic at Dessie Referral Hospital, Northeast Ethiopia: A Retrospective Cohort Study

Incidence and Predictors of Loss to Follow-Up Among Children Attending ART Clinics in Northeast Ethiopia: A Retrospective Cohort Study

Loss to follow-up in “test and treat era” and its predictors among HIV-positive adults receiving ART in Northwest Ethiopia: Institution-based cohort study

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