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. 2023 Jul 17:4:1128988.
doi: 10.3389/fgwh.2023.1128988. eCollection 2023.

Incidence and predictors of loss to follow-up among pregnant and lactating women in the Option B+ PMTCT program in Northwestern Ethiopia: a seven-year retrospective cohort study

Melkalem Mamuye Azanaw  1 , Adhanom Gebreegziabher Baraki  2 , Melaku Kindie Yenit  2
Affiliations

Incidence and predictors of loss to follow-up among pregnant and lactating women in the Option B+ PMTCT program in Northwestern Ethiopia: a seven-year retrospective cohort study

Melkalem Mamuye Azanaw et al. Front Glob Womens Health. .

Abstract

Introduction: Although Ethiopia has implemented the Option B+ program over the past 7 years, loss to follow-up among HIV-positive women remains a major problem for antiretroviral therapy (ART) treatment. This study was conducted to investigate the number of women who dropped out of follow-up after the Option B+ program.

Methods: A retrospective follow-up study was conducted among 403 pregnant and lactating women between June 2013 and December 2019 at health facilities in Northwest Ethiopia. The Cox proportional hazards regression model was used to identify predictors of loss to follow-up. The results were reported as hazard ratios with 95% confidence intervals (CIs) at a significance level of p = 0.05.

Results: The overall incidence rate of loss to follow-up was 9.4 per 1,000 person-months of observation (95% CI: 7.40-11.90). According to the multivariable Cox regression, rural residency [adjusted hazard ratio (AHR): 2.30; 95% CI: 1.08-4.88], being a Muslim religion follower (AHR: 2.44; 95% CI: 1.23-4.81), having no baseline viral load measurement (AHR: 4.21; 95% CI: 2.23-7.96), being on ART before enrolment (AHR: 0.30; 95% CI: 0.15-0.62), having drug side effects (AHR:1.82; 95% CI: 1.01-3.33), same-day ART initiation (AHR: 3.23; 95% CI: 1.53-6.84), and having suboptimal adherence level (AHR: 3.96; 95% CI: 2.18-7.19) were significant predictors of loss to follow-up.

Conclusion: The incidence of loss to follow-up is lower as compared to evidence from most African countries but slightly higher than the WHO target. It is better to strengthen and expand viral load measurements for all women and to pay attention to women residing in rural areas with fair or poor adherence levels.

Keywords: HIV; Northwest Ethiopia; PMTCT; loss to follow-up; option B+; women.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Consort diagram with total number of eligible patients and final number of women included in the analysis.
Figure 2
Figure 2
Incidence of LTFU by enrolment year among pregnant and breastfeeding women on Option B+ PMTCT program from June 2013–December 2019 in Northwest Ethiopia.
Figure 3
Figure 3
Kaplan–Meier survival estimate of LTFU among pregnant and breastfeeding women on Option B+ PMTCT program from June 2013–December 2019 in Northwest Ethiopia.
Figure 4
Figure 4
Cumulative hazard estimate of LTFU among pregnant and breastfeeding women on Option B+ PMTCT program by from June 2013–December 2019 in Northwest Ethiopia by enrolment status.
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References

    1. Vrazo AC, Sullivan D, Ryan Phelps B. Eliminating mother-to-child transmission of HIV by 2030: 5 strategies to ensure continued progress. J Glob Health Sci Pract. (2018) 6(2):249–56. 10.9745/GHSP-D-17-00097 - DOI - PMC - PubMed
    1. World Health Organization (WHO). Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection: Recommendations for a public health approach. 2nd ed. Geneva: World Health Organization: (2016). - PubMed
    1. Joint United Nations Programme on HIV/AIDS. Start free stay free AIDS free. Progress report. Geneva, Switzerland (2019). Available at: https://www.unaids.org/en/resources/documents/2019/20190722_UNAIDS_SFSFA...
    1. https://www.unaids.org/en/resources/fact-sheet United Nations Programme on HIV/AIDS (UNAIDS): Global HIV & AIDS statistics — fact sheet. Geneva, Switzerland (2018). Available at:
    1. World Health Organization (WHO). Programmatic update use of antiretroviral drugs for treating pregnant women and preventing HIV infection in infants. Geneva: HIV/AIDs Program; (2012).