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Observational Study
. 2018 Jun 18;18(1):280.
doi: 10.1186/s12879-018-3188-4.

Predictors of loss to follow up among adult clients attending antiretroviral treatment at Karamara general hospital, Jigjiga town, Eastern Ethiopia, 2015: a retrospective cohort study

Wubareg Seifu  1 , Walid Ali  2 , Beyene Meresa  3
Affiliations
Observational Study

Predictors of loss to follow up among adult clients attending antiretroviral treatment at Karamara general hospital, Jigjiga town, Eastern Ethiopia, 2015: a retrospective cohort study

Wubareg Seifu et al. BMC Infect Dis. .

Abstract

Background: Retention in care and adherence to the treatment is very important for the success of the program while access for treatment is being scaled up. Without more precise data about the rate of loss to follow up as well the characteristics of those who disengage from the treatment appropriate interventions to increase ART adherence cannot be designed and implemented. Therefore the aim of this study was to determine incidence and predictors of loss to follow up among adult ART clients attending in Karamara Hospital, Jigjiga town, Eastern Ethiopia, 2015.

Methods: An institutional based retrospective cohort study were undertaken among 1439 adult people living with HIV/AIDS and attending ART clinic between September 1, 2007 and September 1, 2014 at Karamara Hospital was undertaken. Loss to follow up was defined as not taking an ART refill for a period of 90 days or longer from the last attendance for refill and not yet classified as 'dead' or 'transferred-out'. A Kaplan-Meier model was used to estimate rate of time to loss to follow up and Cox proportional hazards modeling was used to identify predictors of loss to follow up among ART clients.

Result: Of 1439 patients, 830(58.0%) were females in their sex. The mean age of the cohort was 33.5 years with a standard deviation of 9.33. Around 213 (14.8%) patients were defined as LTFU. The incidence rate of loss to follow up in the cohort was 26.6% (95% CI; 18.1-29.6) per 100 person months. Patients with male sex [HR: 2.1CI;(1.3-3.4)], patients whose next appointment weren't recorded [HR: 1.2, 95% CI; (1.12-1.36)] and patients who did not disclose their status to any one [HR: 2.8, 95% CI; (2.22-5.23)] were significantly associated with LTFU in the cox proportional model.

Conclusion: Overall, these data suggested that LTFU in this study was high. The ART patients' next appointment should be documented very well and as well the clients should be advised to adhere with treatment program as per the schedule. Defaulter tracing mechanism should be operational and strengthen in the health facility. Effective control measures should be designed for at-risk population such as male patients.

Keywords: ART; Eastern Ethiopia; Jigjiga town; Loss to follow up; Predictors.

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Conflict of interest statement

Authors information

WS; Lecturer of Epidemiology and Biostatistics, Head of Public Health department, College of Medicine and Health Sciences, Jigjiga University, Jigjiga Town, Eastern Ethiopia; WA; Saint Paul’s Hospital Millennium Medical College, Department of Radiology, Addis Ababa, Ethiopia; BM. School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia.

Ethical approval and consent to participate

Approved by the ethical review board of Jigjiga University, College Medicine and Health Sciences. An official support letter was obtained from the medical director of the Hospital and the ART department as well. Written informed consent from study participants were not feasible since this was analysis of secondary data retrieved from the patient cards/database which is available in the Hospital. Because of this reason the ethical committee of the university waived written consent from the study participants directly. The hospital database management department had consented each HIV/AIDS patients to use the data for research purpose through confidential way at the time of enrolment to the ART program.

Consent for publication

Not applicable

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Profiles of HIV/AIDS clients at Karamara Hospital, Jigjiga (September 1, 2007 to September 1, 2014, Ethiopian Somali Regional State, Eastern Ethiopia; 2015
Fig. 2
Fig. 2
Number of clients retained and loss to follow up from ART program by each year at Karamara General Hospital, from September 1, 2007 to September, 2014, Ethiopian Somali regional State, Eastern Ethiopia, 2015
Fig. 3
Fig. 3
Kaplan-Meier estimation of cumulative incidence of loss to follow up by sex among adult ART attendants at Karamara Hospital, Jigjiga, Ethiopia, 2015
See this image and copyright information in PMC

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