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. 2022 Jun;22(2):12-26.
doi: 10.4314/ahs.v22i2.3.

Incidence and predictors of loss to follow-up among adult HIV-infected patients taking antiretroviral therapy at North Shewa zone public Hospitals, Northeast Ethiopia: A retrospective follow-up study

Wondimeneh Shibabaw Shiferaw  1 , Abebe Muche Belete  2 , Alemu Adela  2 , Mekasha Getnet  1 , Yared Asmare Aynalem  1
Affiliations

Incidence and predictors of loss to follow-up among adult HIV-infected patients taking antiretroviral therapy at North Shewa zone public Hospitals, Northeast Ethiopia: A retrospective follow-up study

Wondimeneh Shibabaw Shiferaw et al. Afr Health Sci. 2022 Jun.

Abstract

Background: Patients who are lost to follow-up while on treatment compromise their own health and the long-term success of antiretroviral therapy (ART) programs. Besides, loss to follow-up (LTFU) increases HIV-related morbidity and mortality. Therefore, this study aimed to determine the incidence of LTFU and its predictors among adult HIV positive patients on anti-retroviral therapy at North Shoa zone public hospitals, Northeast Ethiopia.

Methods: A retrospective follow up study of 517 people living with HIV/AIDS and attending an ART clinic between 2015 and 2020 was conducted at North Shewa zone, public hospitals. Kaplan-Meier failure function together with log rank test was used to compare failure function. Multivariable Cox proportion hazards regression model was used to determine predictors of LTFU.

Result: The incidence density rate of lost to follow up among HIV positive adult on ART was found to be 8.9 per 100 adult years observation (95%CI; 7.45, 10.68). In multivariable cox proportional regression analysis, WHO clinical stage-IV (AHR = 1.50; 95% CI: 1.08, 3.75), comorbidity disease (AHR = 0.54; 95% CI; 0.30, 0.97), body mass index less than 18kg/m2 (AHR = 1.60; 95% CI; 1.02, 2.51), cotrimoxazole preventive therapy (AHR = 1.57; 95% CI;1.09, 2.53), and a low CD4 count (AHR = 1.66; 95% CI; 1.29, 3.49) were found to be a significant predictors of lost to follow up.

Conclusion: The current study showed that the incidence rate of loss to ART follow-up was high. Body mass index score less than 18kg/m2, advanced WHO clinical stage, CD4<200cell/mm3, had comorbidity disease, and cotrimoxazole therapy were a significant predictors of lost to ART follow up. Therefore, appropriate mitigation measures in the at-risk group need to be instigated to advance retention rate.

Keywords: ART; Ethiopia; HIV/AIDS; lost to follow up; predictors.

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Figures

Figure 1
Figure 1
The overall hazard rate of lost to ART follow-up among HIV-positive adult individuals at North Shoa, public hospitals, Northeast Ethiopia.
Figure 2
Figure 2
The hazard rate of lost to follow-up of HIV-positive adults on ART by their WHO clinical stage
Figure 3
Figure 3
The hazard rate of lost to follow-up of HIV-positive adults on ART by their baseline anemic status
Figure 4
Figure 4
The hazard rate of lost to follow-up of HIV-positive adults on ART by their comorbidity status
Figure 5
Figure 5
The hazard rate of lost to follow-up of HIV-positive adults on ART by their cotrimoxazole therapy
Figure 6
Figure 6
Cox-Snell residual Nelson -Aalen cumulative hazard graph on lost to follow up in North Shoa zone, public hospitals, northeast Ethiopia
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