Incidence and predictors of loss to follow-up among adult patients receiving antiretroviral therapy in Central Ethiopia: a multi-center retrospective cohort study
BackgroundGlobally, loss to follow-up (LTFU) remains a significant public health concern despite the rapid expansion of antiretroviral medication programs. It is a significant cause of treatment failure and threatens the enhancement of HIV treatment outcomes among patients on antiretroviral therapy...
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Frontiers Media S.A.
2024-03-01
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| Series: | Frontiers in Public Health |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fpubh.2024.1374515/full |
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| author | Asfaw Anulo Addisu Girma Gezahegn Tesfaye Fekede Asefa Abera Cheru Arega Abebe Lonsako |
| author_facet | Asfaw Anulo Addisu Girma Gezahegn Tesfaye Fekede Asefa Abera Cheru Arega Abebe Lonsako |
| author_sort | Asfaw Anulo |
| collection | DOAJ |
| description | BackgroundGlobally, loss to follow-up (LTFU) remains a significant public health concern despite the rapid expansion of antiretroviral medication programs. It is a significant cause of treatment failure and threatens the enhancement of HIV treatment outcomes among patients on antiretroviral therapy (ART). However, there is a paucity of evidence on its incidence and predictors in Ethiopia. Thus, this study aimed to examine the incidence and predictors of LTFU among adult HIV patients receiving ART at hospitals in Central Ethiopia.MethodsA multi-centered facility-based retrospective cohort study was conducted among 432 randomly selected adult patients who received antiretroviral therapy. Data were entered into EpiData version 3.1 and exported to Stata version 14 for analysis. The Kaplan–Meier failure function was employed to determine the overall failure estimates, and the log-rank test was used to compare the probability of failure among the different categories of variables. The Cox proportional hazard model was used to identify independent predictors of LTFU.ResultsOverall, 172 (39.8%) study participants were lost to follow-up over the 10-year follow-up period with an incidence rate of 8.12 (95% CI: 7.11, 9.09) per 1,000 person-months. Undisclosed HIV status (AHR: 1.96, 95% CI: 1.14, 3.36), not able to work (AHR: 1.84, 95% CI: 1.13, 2.22), opportunistic infections (AHR: 3.13, 95% CI: 2.17, 4.52), CD4 < 200 cell/mL (AHR: 1.95, 95% CI: 1.18, 3.21), not receiving isoniazid preventive therapy (IPT) (AHR: 2.57, 95% CI: 1.62, 4.06), not participating in clubs (AHR: 1.68, 95% CI: 1.10, 2.22), side effects of drugs (AHR: 1.44, 95% CI: 1.02, 2.04), and high viral load (AHR: 3.15, 95% CI: 1.81, 5.47) were identified as significant predictors of loss to follow-up.ConclusionIn this study, the incidence of LTFU was high. The focus should be on creating awareness and prevention programs that aim to reduce loss to follow-up by continuing counseling, especially on the negative effects of loss to follow-up and the benefits of ART care. |
| first_indexed | 2024-04-25T00:16:13Z |
| format | Article |
| id | doaj.art-ff8037fe36a34a8d9dac0e19142bb480 |
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| issn | 2296-2565 |
| language | English |
| last_indexed | 2024-04-25T00:16:13Z |
| publishDate | 2024-03-01 |
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| spelling | doaj.art-ff8037fe36a34a8d9dac0e19142bb4802024-03-13T04:46:06ZengFrontiers Media S.A.Frontiers in Public Health2296-25652024-03-011210.3389/fpubh.2024.13745151374515Incidence and predictors of loss to follow-up among adult patients receiving antiretroviral therapy in Central Ethiopia: a multi-center retrospective cohort studyAsfaw Anulo0Addisu Girma1Gezahegn Tesfaye2Fekede Asefa3Abera Cheru4Arega Abebe Lonsako5Dr Bogalech Gebre Memorial General Hospital, Durame, EthiopiaDr Bogalech Gebre Memorial General Hospital, Durame, EthiopiaCollege of Health and Medical Science, Haramaya University, Harar, EthiopiaDepartment of Pediatrics, The University of Tennessee Health Science Center (UTHSC) – Oak Ridge National Laboratory (ORNL) Center for Biomedical Informatics, Memphis, TN, United StatesSchool of Environmental Health Science, College of Health and Medical Science, Haramaya University, Harar, EthiopiaCollege of Medicine and Health Science, Arba Minch University, Arba Minch, EthiopiaBackgroundGlobally, loss to follow-up (LTFU) remains a significant public health concern despite the rapid expansion of antiretroviral medication programs. It is a significant cause of treatment failure and threatens the enhancement of HIV treatment outcomes among patients on antiretroviral therapy (ART). However, there is a paucity of evidence on its incidence and predictors in Ethiopia. Thus, this study aimed to examine the incidence and predictors of LTFU among adult HIV patients receiving ART at hospitals in Central Ethiopia.MethodsA multi-centered facility-based retrospective cohort study was conducted among 432 randomly selected adult patients who received antiretroviral therapy. Data were entered into EpiData version 3.1 and exported to Stata version 14 for analysis. The Kaplan–Meier failure function was employed to determine the overall failure estimates, and the log-rank test was used to compare the probability of failure among the different categories of variables. The Cox proportional hazard model was used to identify independent predictors of LTFU.ResultsOverall, 172 (39.8%) study participants were lost to follow-up over the 10-year follow-up period with an incidence rate of 8.12 (95% CI: 7.11, 9.09) per 1,000 person-months. Undisclosed HIV status (AHR: 1.96, 95% CI: 1.14, 3.36), not able to work (AHR: 1.84, 95% CI: 1.13, 2.22), opportunistic infections (AHR: 3.13, 95% CI: 2.17, 4.52), CD4 < 200 cell/mL (AHR: 1.95, 95% CI: 1.18, 3.21), not receiving isoniazid preventive therapy (IPT) (AHR: 2.57, 95% CI: 1.62, 4.06), not participating in clubs (AHR: 1.68, 95% CI: 1.10, 2.22), side effects of drugs (AHR: 1.44, 95% CI: 1.02, 2.04), and high viral load (AHR: 3.15, 95% CI: 1.81, 5.47) were identified as significant predictors of loss to follow-up.ConclusionIn this study, the incidence of LTFU was high. The focus should be on creating awareness and prevention programs that aim to reduce loss to follow-up by continuing counseling, especially on the negative effects of loss to follow-up and the benefits of ART care.https://www.frontiersin.org/articles/10.3389/fpubh.2024.1374515/fulladultsincidenceantiretroviral therapyLTFUpredictors |
| spellingShingle | Asfaw Anulo Addisu Girma Gezahegn Tesfaye Fekede Asefa Abera Cheru Arega Abebe Lonsako Incidence and predictors of loss to follow-up among adult patients receiving antiretroviral therapy in Central Ethiopia: a multi-center retrospective cohort study Frontiers in Public Health adults incidence antiretroviral therapy LTFU predictors |
| title | Incidence and predictors of loss to follow-up among adult patients receiving antiretroviral therapy in Central Ethiopia: a multi-center retrospective cohort study |
| title_full | Incidence and predictors of loss to follow-up among adult patients receiving antiretroviral therapy in Central Ethiopia: a multi-center retrospective cohort study |
| title_fullStr | Incidence and predictors of loss to follow-up among adult patients receiving antiretroviral therapy in Central Ethiopia: a multi-center retrospective cohort study |
| title_full_unstemmed | Incidence and predictors of loss to follow-up among adult patients receiving antiretroviral therapy in Central Ethiopia: a multi-center retrospective cohort study |
| title_short | Incidence and predictors of loss to follow-up among adult patients receiving antiretroviral therapy in Central Ethiopia: a multi-center retrospective cohort study |
| title_sort | incidence and predictors of loss to follow up among adult patients receiving antiretroviral therapy in central ethiopia a multi center retrospective cohort study |
| topic | adults incidence antiretroviral therapy LTFU predictors |
| url | https://www.frontiersin.org/articles/10.3389/fpubh.2024.1374515/full |
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