Predictors associated with HIV/AIDS patients dropout from antiretroviral therapy at Mettu Karl Hospital, southwest Ethiopia

Tadege, Melaku

doi:10.1186/s13104-019-4267-3

Cited by 5 publications

(11 citation statements)

References 48 publications

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“…Five original papers stated that marital status was associated with patient retention in clinical care. Of which three articles reported that married people were less likely to be lost to follow up [8,30,51] and the probability of dropout for patients with separated marital status was about 16.82% higher than those patients with marital status divorced [41]. Another article [44] reported as single marital status as an independent predictor of death.…”

Section: Factors Related To Patient Retention and Attrition Socio-demmentioning

confidence: 99%

“…Similarly, eight papers [17,22,23,28,30,36,49,54] reported that young age was an important predictor of loss to follow up but this was not statistically significant in the pooled analysis (OR, 0.88, 95% CI, 0.27-2.89). Four papers reported that educational status had an influence on retention in care [10,30,41,54]. All except one [41] primary articles has reported that people with no or primary education were more likely to experience loss to follow up compared to those with secondary and above educational level.…”

Section: Factors Related To Patient Retention and Attrition Socio-demmentioning

confidence: 99%

“…Four papers reported that educational status had an influence on retention in care [10,30,41,54]. All except one [41] primary articles has reported that people with no or primary education were more likely to experience loss to follow up compared to those with secondary and above educational level. Two studies reported that urban residents were better in retention than their rural counterparts [22,49].…”

Section: Factors Related To Patient Retention and Attrition Socio-demmentioning

confidence: 99%

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HIV patients retention and attrition in care and their determinants in Ethiopia: a systematic review and meta-analysis

et al. 2020

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Background: There is paucity of evidence on the magnitude of HIV patients' retention and attrition in Ethiopia. Hence, the aim of this study was to determine the pooled magnitude of HIV patient clinical retention and attrition and to identify factors associated with retention and attrition in Ethiopia. Methods: Systematic review and meta-analysis were done among studies conducted in Ethiopia using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. Both published and unpublished studies conducted from January 1, 2005 to June 6th, 2019 were included. Major databases and search engines such as Google Scholar, PUBMED, African Journals Online (AJOL) and unpublished sources were searched to retrieve relevant articles. Data were assessed for quality, heterogeneity and publication bias. Analysis was conducted using STATA version 14 software. Result: From a total of 45 studies 546,250 study participants were included in this review. The pooled magnitude of retention in care among HIV patients was 70.65% (95% CI, 68.19, 73.11). The overall magnitude of loss to follow up 15.17% (95% CI, 11.86, 18.47), transfer out 11.17% (95% CI, 7.12, 15.21) and death rate were 6.75% (95% CI, 6.22, 7.27). Major determinants of attrition were being unmarried patient (OR 1.52, 95% CI: 1.15-2.01), non-disclosed HIV status (OR 6.36, 95% CI: 3.58-11.29), poor drug adherence (OR 6.60, 95% CI: 1.41-30.97), poor functional status (OR 2.11, 95% CI: 1.33-3.34), being underweight (OR 2.21, 95% CI: 1.45-3.39) and advanced clinical stage (OR 1.85, 95% CI: 1.36-2.51). Whereas absence of opportunistic infections (OR 0.52, 95% CI: 0.30-0.9), normal hemoglobin status (OR 0.29, 95% CI: 0.20-0.42) and non-substance use (OR 95% CI: 0.41, 0.17-0.98) were facilitators of HIV patient retention in clinical care. Conclusion: The level of retention to the care among HIV patients was low in Ethiopia. Socioeconomic , clinical, nutritional and behavioral, intervention is necessary to achieve adequate patient retention in clinical care.

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Section: Factors Related To Patient Retention and Attrition Socio-demmentioning

confidence: 99%

Section: Factors Related To Patient Retention and Attrition Socio-demmentioning

confidence: 99%

Section: Factors Related To Patient Retention and Attrition Socio-demmentioning

confidence: 99%

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HIV patients retention and attrition in care and their determinants in Ethiopia: a systematic review and meta-analysis

et al. 2020

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“…That means, Patient's baseline CD4+ count significantly impact on his or her survival attending follow-up time. This study was agreed to a study by [10] in Ethiopia.…”

Section: Discussionmentioning

confidence: 95%

“…Based on WHO report, out of the registered HIV patient's the measurement of achievement was only 23%. ART lost from follow-up negatively affects the improvement of an immunological advantage and increases HIV/AIDS related mortality [10]. Lost follow-up of ART will be the reason for drug toxicity, treatment poor adherence and medication resistance this results to mortality [11].…”

Section: Introductionmentioning

confidence: 99%

Statistical Joint Modeling of Longitudinal CD4 Cell variation and Time-to-Lost Follow-up from ART Predictors on HIV/AIDS Patients: A case of Mekelle General Hospital

Gebrerufael¹

2020

Preprint

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Back ground: Time-to-lost follow-up and CD4 cell variation measures are the outcome variables of infection in HIV/AIDS patients after starting ART in this study. The time-to-lost follow-up from ART was determined by month time interval among dates of ART commencement to drop-out, as documented by the health information data administrator. The main goal of this study was to identify association of CD4 cell variation measurements on time-to-lost follow-up and main predictors of HIV/AIDS positive patients.Methods: Institution based retrospective cohort study design was used among 216 HIV/AIDS patients under ART follow-up from period September 11, 2013 to September 5, 2016 at Mekelle General Hospital, Ethiopia and employed both survival and longitudinal outcome to fit separate and statistical joint modeling approach.Results: A total of 216 HIV/AIDS patients were selected using systematic random sampling technique to analyze the longitudinal and survival outcome using joint model study. The result of this study showed that relationship between CD4 cell variation on hazard of time-to-lost follow-up was negatively statistical significant. Thus, time-to-lost follow-up from ART is less probable to occur in HIV/AIDS patients which have higher CD4 cell evolution. In survival sub-model Baseline CD4, sex of male, living in rural and comorbidity HIV/TB were significant factors of risk to time-to-lost follow-up from ART of HIV/AIDS patients. The longitudinal sub-model shows Baseline CD4 cell and being bedridden were significant factors of variation at 5% significance levels.Conclusions: The author assessed relationship of repeated measured CD4 cell variation on hazard of time-to-lost follow-up was negatively statistical significant and performance of both separate and statistical joint sub-models in terms model parsimony, smaller AIC & smaller standard error in statistical joint model performs. Thus, the author concluded that statistical joint model was preferred for simultaneous analyses of repeated biomarker CD4 cell and survival time-to-lost follow-up data.

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Predicting Lost to Follow-Up Status Using an Adolescent HIV Psychosocial Attrition Risk Assessment Tool: Results From a Mixed Methods Prospective Cohort Study in Uganda

Medina-Jaudes,

Adoa,

Williams

et al. 2024

JAIDS Journal of Acquired Immune Deficiency Syndromes

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Background: Low retention in care for adolescents living with HIV (ALHIV) has been a key driver of sub-optimal viral load suppression rates in Uganda. The objective of the study was to develop a psychosocial risk assessment tool and evaluate its ability to predict risk of attrition of ALHIV between the ages of 15 and 19. Setting: The study was conducted in 20 facilities in Central and Western Uganda from August 2021 through July 2022. Methods: A mixed methods prospective cohort study was conducted in two phases. In the first phase, the Adolescent Psychosocial Attrition Risk Assessment (APARA) tool was developed and revised using feedback from focus group discussions and interviews. In the second phase, the ability of the APARA tool to predict attrition among ALHIV was evaluated using diagnostic accuracy tests. Results: A total of 597 adolescents between the ages of 15 and 19 were enrolled, of which 6% were lost-to-follow-up (LTFU) at the end of the study period. A 20-question tool was developed, with 12 questions being responded to affirmatively by more than 50% of all participants. Using a cut-off score of six or more affirmative answers translated to an area under the curve of 0.58 (95% CI: 0.49-0.66), sensitivity of 55% (95% CI: 36-72%) and specificity of 61% (95% CI: 56-65%). Conclusion: While the APARA tool was not effective at predicting LTFU status among ALHIV, the tool was useful for identifying psychosocial issues experienced by ALHIV and may be appropriate to administer during routine care visits to guide action.

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Predictors associated with HIV/AIDS patients dropout from antiretroviral therapy at Mettu Karl Hospital, southwest Ethiopia

Cited by 5 publications

References 48 publications

HIV patients retention and attrition in care and their determinants in Ethiopia: a systematic review and meta-analysis

HIV patients retention and attrition in care and their determinants in Ethiopia: a systematic review and meta-analysis

Statistical Joint Modeling of Longitudinal CD4 Cell variation and Time-to-Lost Follow-up from ART Predictors on HIV/AIDS Patients: A case of Mekelle General Hospital

Predicting Lost to Follow-Up Status Using an Adolescent HIV Psychosocial Attrition Risk Assessment Tool: Results From a Mixed Methods Prospective Cohort Study in Uganda

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