Abstract:
Background: The positive health outcomes of ART are challenged by loss to follow-up. Factors associated with LTFU remain complex. Few researches have been conducted in Ethiopia to investigate the incidence and predictors of LTFU and no specific research has conducted in Gedeo zone. The current study aimed to determine the incidence and predictors of loss to follow up among HIV patients enrolled in antiretroviral treatment at Dilla University Referral Hospital.
Objective:-To determine the incidence of loss to follow up and its predictors among adult HIV patients enrolled in ART in Dilla University Referral Hospital, Gedeo Zone, Southern Ethiopia.
Method:- The five-year institution based retrospective follow up study was conducted. Sample size was determined using STATA software for survival analysis sample size determination. Sampling was carried out using simple random sampling technique. Data analysis was carried out using STATA 16.1. Descriptive statistics was employed to summarize study subjects. Incident rate was calculated per 100 person-year with 95% confidence interval. Kaplan-Meier failure curve was employed to estimate time to loss to follow up after initiation of antiretroviral treatment. Log rank test was used to test the significance of observed differences between groups. Proportional hazards regression (Cox regression) model was used to identify factors associated with time to loss to follow up, by estimating hazard ratio with 95% confidence interval.
Result:- A total follow-up time for 237 patients on antiretroviral treatment was 374.24 person-years observation with an incidence rate of 23.25% (95% CI 18.24, 26.68) per 100 person-years of follow up. Divorced marital status (AHR: 3.05: 95%CI: 1.4, 6.69), farmers (AHR: .21: 95%CI: .09, .49), government employees (AHR: .18: 95%CI: .07, .48), house wife (AHR: .21: 95%CI: .09, .51, merchant (AHR: .18: 95%CI: .06, .55), student (AHR: .24: 95%CI: .08, .75) , patients who received co-trimoxazole preventive therapy (AHR: .5: 95%CI: .27, .93) and WHO clinical stage IV (AHR: 7.07: 95%CI: 2.06, 24.26) were significant predictors of LTFU.
Conclusions and Recommendations: - In this study the incidence rate of LTFU was relatively higher than most of the studies conducted in Ethiopia. Divorced marital status, WHO clinical stage IV, co-trimoxazole preventive therapy, occupation categories including farmer, house wife government employee, merchant and students were significant predictors of loss to follow up. Clinicians should consider the identified risk factors while giving ART service and counseling to decrease LTFU.
Biography:
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