Loss to follow‐up of patients in HIV care in Burundi: A retrospective cohort study

Abstract

The objective was to assess the loss to follow-up (LTFU) rates and associated factors amongst patients in HIV care in Burundi. METHODS:We conducted a retrospective cohort study in HIV-positive patients aged ≥15 years who started antiretroviral therapy (ART) between January 2015 and July 2020, with 31 December 2020 as the end point. The outcome of LTFU was defined as failure of a patient to report for drug refill within 90 days from the last appointment. Study data were extracted from the national AIDS Info database. The LTFU proportion was determined using the Kaplan-Meier method with the log-rank test, whereas LTFU risk factors were explored using the Cox regression model. RESULTS: A total of 29,829 patients on ART were included in the analysis. Cumulative incidence of LTFU was 2.3% at 12 months, 6.5% at 24 months, 12.7% at 36 months, 19.0% at 48 months, 24.1% at 60 months and 25.3% at 72 months. The overall LTFU incidence rate was 11.2 per 100 person-years of observation. The risk of LTFU was higher amongst patients who started ART after 2016 (adjusted hazard ratio [aHR] 1.75, 95% confidence interval [CI] 1.65-1.85) or within 7 days after diagnosis (aHR 1.27, 95% CI 1.21-1.35). CONCLUSION: Our findings demonstrate the relatively high incidence of LTFU in the Burundi HIV programme. Interventions targeting patients with risk factors for LTFU are particularly necessary.

Predictors of loss to follow up among adults on antiretroviral therapy before and after the start of treat-all strategy in public health facilities of Hawassa city, Ethiopia: A Competing risk regression

“…The incidence of LTFU was 8.67 per 100 person-years in the treat-all period was consistent with 8.9 per 100 person-year reported from North Shewa zone, public hospitals [44]. However, it was lower than the previous studies conducted at Felege Hiwot Comprehensive Specialized Hospital, Northwest Ethiopia [45] and Burundi [46]. The differences might be due to the differences in baseline clinical, the occurrence of opportunistic infection, and nutritional characteristics of the patients, as low immunological status was a key criterion for treatment initiation in the pre-treat-all era, impacting care retention.…”

Factors associated with ART interruption during the COVID-19 crisis in Burundi (the EPIC community-based research program)

“…In the present study, 11.7% of participants reported ART interruption during the first year of the COVID-19 pandemic in Burundi. In 2020, loss to follow-up in Burundi was estimated at 6.5% two years after ART initiation 29 . The reasons for ART interruption given by the participants in our study reflect the factors highlighted in the multivariable analysis.…”

Factors Contributing to Loss to Follow-Up from HIV Care Among Men Living with HIV/AIDS in Kibaha District, Tanzania

“…HIV/AIDS -Research and Palliative Care 2022:14 504 participants were referred as LTFU if they had not attended the clinic for at least 90 days after their last appointment date for drug refill, yet were not recorded as dead or transferred-out. 26,27…”