Proportion of Attrition and Associated Factors Among Children Receiving Antiretroviral Therapy in Public Health Facilities, Southern Ethiopia.

IF 1.5 Q4 INFECTIOUS DISEASES

HIV AIDS-Research and Palliative Care Pub Date : 2023-01-01 DOI:10.2147/HIV.S422173

Tamirat Gezahegn Guyo, Temesgen Mohammed Toma, Desta Haftu, Mesfin Kote, Fasika Merid, Kebede Kulayta, Markos Makisha, Kidus Temesgen

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Abstract

Purpose: Acquired immunodeficiency syndrome (AIDS) is a major global public health concern. Despite the improved access and utilization of antiretroviral therapy (ART), attrition from care among children continues to be a major obstacle to the effectiveness of ART programs. Hence, this study aimed to assess the proportion of attrition and associated factors among children receiving ART in public health facilities of Gamo and South Omo Zones, Southern Ethiopia.

Patients and methods: A retrospective follow-up study was conducted in public health facilities of Gamo and South Omo Zones in Southern Ethiopia from April 12, 2022, to May 10, 2022. The proportion of attrition was determined by dividing the number of attrition by the total number of participants. Descriptive statistics were calculated. A binary logistic regression model was used to identify factors associated with attrition. Statistical significance was set at p-value <0.05.

Results: The median age of the participants was 5.5 (IQR: 2-9) years. The proportion of attrition from ART care was 32.4% (95% confidence interval (CI): 27.57% to 37.69%). Death of either of the parents (adjusted odds ratio (AOR) = 2.19; 95% CI:1.14, 4.18), or both parents (AOR = 3.19; 95% CI: 1.20, 8.52), hemoglobin level <10mg/dL (AOR = 2.39, 95% CI: 1.21, 4.70), a cluster of differentiation (CD)4 count ≤200 cells/mm³ (AOR = 6.78, 95% CI: 3.16, 14.53), CD4 count 200-350 cells/mm³ (AOR = 2.65, 95% CI: 1.16, 6.03), suboptimal adherence (AOR = 6.38; 95% CI: 3.36, 12.19), and unchanged initial regimen (AOR = 6.88; 95% CI: 3.58, 13.19) were factors associated with attrition.

Conclusion: Attrition from care is identified to be a substantial public health problem. Therefore, designing interventions to improve the timely tracing of missed follow-up schedules and adherence support is needed, especially for children with either/both parents died, unchanged initial regimen, low CD4, and/or low hemoglobin level.

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埃塞俄比亚南部公共卫生机构中接受抗逆转录病毒治疗的儿童的减员比例及相关因素。

目的:获得性免疫缺陷综合征(艾滋病)是一个主要的全球公共卫生问题。尽管抗逆转录病毒治疗(ART)的可及性和利用程度有所提高，但儿童对治疗的耗损仍然是影响抗逆转录病毒治疗方案有效性的主要障碍。因此，本研究旨在评估埃塞俄比亚南部加莫和南奥莫地区公共卫生设施中接受抗逆转录病毒治疗的儿童的减员比例及其相关因素。患者和方法:于2022年4月12日至2022年5月10日在埃塞俄比亚南部加莫和南奥莫地区的公共卫生机构进行了一项回顾性随访研究。减员比例由减员人数除以参与者总数确定。进行描述性统计。使用二元逻辑回归模型来确定与磨耗相关的因素。结果:参与者的中位年龄为5.5 (IQR: 2-9)岁。ART治疗的减员比例为32.4%(95%可信区间(CI): 27.57% ~ 37.69%)。父母一方死亡(调整优势比= 2.19;95% CI:1.14, 4.18)或父母双方(AOR = 3.19;95% CI: 1.20, 8.52)，血红蛋白水平3 (AOR = 6.78, 95% CI: 3.16, 14.53)， CD4细胞计数200-350细胞/mm3 (AOR = 2.65, 95% CI: 1.16, 6.03)，次优粘附(AOR = 6.38;95% CI: 3.36, 12.19)和初始方案不变(AOR = 6.88;95% CI: 3.58, 13.19)是与磨耗相关的因素。结论:护理减员已被确定为一个重大的公共卫生问题。因此，需要设计干预措施，以改善对错过的随访计划的及时追踪和依从性支持，特别是对于父母一方或双方死亡，初始方案不变，CD4低和/或血红蛋白水平低的儿童。

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来源期刊

HIV AIDS-Research and Palliative Care INFECTIOUS DISEASES-

CiteScore

3.00

自引率

6.70%

发文量

审稿时长

16 weeks

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