Incidence and predictors of loss to follow-up among HIV-positive adults in northwest Ethiopia: a retrospective cohort study.

Birhanu, MY; Leshargie, CT; Alebel, A; Wagnew, F; Siferih, M; Gebre, T; Kibret, GD

Incidence and predictors of loss to follow-up among HIV-positive adults in northwest Ethiopia: a retrospective cohort study.

Birhanu, MY Leshargie, CT Alebel, A Wagnew, F Siferih, M Gebre, T Kibret, GD

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Publisher:: Springer Science and Business Media LLC
Publication Type:: Journal Article
Citation:: Tropical medicine and health, 2020, 48, (1), pp. 78
Issue Date:: 2020-01

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Field	Value	Language
dc.contributor.author	Birhanu, MY
dc.contributor.author	Leshargie, CT
dc.contributor.author	Alebel, A
dc.contributor.author	Wagnew, F
dc.contributor.author	Siferih, M
dc.contributor.author	Gebre, T
dc.contributor.author	Kibret, GD
dc.date.accessioned	2021-05-23T21:07:33Z
dc.date.available	2020-08-26
dc.date.available	2021-05-23T21:07:33Z
dc.date.issued	2020-01
dc.identifier.citation	Tropical medicine and health, 2020, 48, (1), pp. 78
dc.identifier.issn	1348-8945
dc.identifier.issn	1349-4147
dc.identifier.uri	http://hdl.handle.net/10453/149085
dc.description.abstract	<h4>Background</h4>Despite the rapid expansion of antiretroviral therapy services, 'loss to follow-up' is a significant public health concern globally. Loss to follow-up of individuals from ART has a countless negative impact on the treatment outcomes. There is, however, limited information about the incidence and predictors of loss to follow-up in our study area. Thus, this study aimed to determine the incidence rate and predictors of loss to follow-up among adult HIV patients on ART.<h4>Methods</h4>A retrospective cohort study was undertaken using 484 HIV patients between January 30, 2008, and January 26, 2018, at Debre Markos Referral Hospital. All eligible HIV patients who fulfilled the inclusion criteria were included in this study. Data were entered into Epi-data Version 4.2 and analyzed using STATA<sup>TM</sup> Version 14.0 software. The Nelson-Aalen cumulative hazard estimator was used to estimate the hazard rate of loss to follow-up, and the log-rank test was used to compare the survival curve between different categorical variables. Both bivariable and multivariable Cox-proportional hazard regression models were fitted to identify predictors of LTFU.<h4>Results</h4>Among a cohort of 484 HIV patients at Debre Markos Referral Hospital, 84 (17.36%) were loss their ART follow-up. The overall incidence rate of loss to follow-up was 3.7 (95% CI 3.0, 5.0) per 100 adult-years. The total LTFU free time of the participants was 2294.8 person-years. In multivariable Cox-regression analysis, WHO stage IV (AHR 2.8; 95% CI 1.2, 6.2), having no cell phone (AHR 1.9; 95% CI 1.1, 3.4), and rural residence (AHR 0.6; 95% CI 0.37, 0.99) were significant predictors of loss to follow-up.<h4>Conclusion</h4>The incidence of loss to ART follow-up in this study was low. Having no cell phone and WHO clinical stage IV were causative predictors, and rural residence was the only protective factor of loss to follow-up. Therefore, available intervention modalities should be strengthened to mitigate loss to follow-up by addressing the identified risk factors.
dc.format	Electronic-eCollection
dc.language	eng
dc.publisher	Springer Science and Business Media LLC
dc.relation.ispartof	Tropical medicine and health
dc.relation.isbasedon	10.1186/s41182-020-00266-z
dc.rights	info:eu-repo/semantics/openAccess
dc.subject	1103 Clinical Sciences, 1108 Medical Microbiology, 1117 Public Health and Health Services
dc.title	Incidence and predictors of loss to follow-up among HIV-positive adults in northwest Ethiopia: a retrospective cohort study.
dc.type	Journal Article
utslib.citation.volume	48
utslib.location.activity	Japan
utslib.for	1117 Public Health and Health Services
utslib.for	1103 Clinical Sciences
utslib.for	1108 Medical Microbiology
utslib.for	1117 Public Health and Health Services
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/Public Health
utslib.copyright.status	open_access	*
dc.date.updated	2021-05-23T21:07:30Z
pubs.issue	1
pubs.publication-status	Published
pubs.volume	48
utslib.citation.issue	1

Abstract:

Background

Despite the rapid expansion of antiretroviral therapy services, 'loss to follow-up' is a significant public health concern globally. Loss to follow-up of individuals from ART has a countless negative impact on the treatment outcomes. There is, however, limited information about the incidence and predictors of loss to follow-up in our study area. Thus, this study aimed to determine the incidence rate and predictors of loss to follow-up among adult HIV patients on ART.

Methods

A retrospective cohort study was undertaken using 484 HIV patients between January 30, 2008, and January 26, 2018, at Debre Markos Referral Hospital. All eligible HIV patients who fulfilled the inclusion criteria were included in this study. Data were entered into Epi-data Version 4.2 and analyzed using STATA^TM Version 14.0 software. The Nelson-Aalen cumulative hazard estimator was used to estimate the hazard rate of loss to follow-up, and the log-rank test was used to compare the survival curve between different categorical variables. Both bivariable and multivariable Cox-proportional hazard regression models were fitted to identify predictors of LTFU.

Results

Among a cohort of 484 HIV patients at Debre Markos Referral Hospital, 84 (17.36%) were loss their ART follow-up. The overall incidence rate of loss to follow-up was 3.7 (95% CI 3.0, 5.0) per 100 adult-years. The total LTFU free time of the participants was 2294.8 person-years. In multivariable Cox-regression analysis, WHO stage IV (AHR 2.8; 95% CI 1.2, 6.2), having no cell phone (AHR 1.9; 95% CI 1.1, 3.4), and rural residence (AHR 0.6; 95% CI 0.37, 0.99) were significant predictors of loss to follow-up.

Conclusion

The incidence of loss to ART follow-up in this study was low. Having no cell phone and WHO clinical stage IV were causative predictors, and rural residence was the only protective factor of loss to follow-up. Therefore, available intervention modalities should be strengthened to mitigate loss to follow-up by addressing the identified risk factors.

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http://hdl.handle.net/10453/149085