Determinants of Loss to Follow Up Among Adult People Living with HIV Enrolled in Antiretroviral Therapy in West Wollega Public Hospitals, Oromia, Ethiopia.
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Abstract
Background: Antiretroviral Treatment (ART) reduces morbidity and mortality in patients with human immunodeficiency virus (HIV). However, clients loss to follow-up (LTFU) from the treatment poses a paramount problem to the public, healthcare, and patient outcome. Thus, this study identified determinants of loss to follow-up to ART among adult clients in West Wollega hospitals, Oromia, Ethiopia, in 2021.
Methods: An unmatched case-control study was conducted and a systematic random sampling technique was used. Data were collected from patient charts by three BSC nurses and three card reporters using a structured checklist. Then, it was entered into Epi-data version 3.1 and analyzed using SPSS version 21. Descriptive statistics (frequency and percentage) were used to present the results. Bivariate and multivariable logistic regression analyses were performed using the backward stepwise method. Adjusted odds ratio (AOR) and p-values <0.05 were used to declare significant association with loss to follow-up. Model fitness was checked using Hosmer-Lemeshow goodness-of-fit.
Results: A total of 399 (133 patients and 266 controls) participated in this study. Rural residents (AOR:3.46, 95% CI:1.65, 7.25), male patient (AOR: 2.65 95% CI 1.54,4.55), lack of formal education (AOR: 4.35, 95% CI 1.53, 12.41), base line CD4 ≤350 (AOR: 5.25, 95% CI 1.93,14.24), poor functional status (AOR: 4.298, 95% CI 5.33,34.62) and WHO stages III & IV (AOR: 2.65, 95% CI 1.68,4.19), and tuberculosis co-infection (AOR: 2.82, 95% CI 1.11,7.45) were determinant factors of loss to follow up.
Conclusion: Rural residence, male sex, daily laborer, no formal education, baseline CD4 count <350 cells/mm3, baseline advanced WHO clinical stage, and TB co-infection were determinants of LTFU. Therefore, emphasis should be given to the identified factors along with awareness creation and health education sessions. Regular TB screening, optimal adherence regardless of their stay on ART, and follow-up study are recommended.
背景：抗逆转录病毒治疗（ART）可降低人类免疫缺陷病毒（HIV）患者的发病率和死亡率。然而，患者失去治疗随访（LTFU）对公众、医疗保健和患者的治疗效果都构成了严重的问题。因此，本研究确定了 2021 年埃塞俄比亚奥罗莫州西沃勒加医院成年患者失去抗逆转录病毒疗法随访的决定因素：方法：采用系统随机抽样技术进行了一项非匹配病例对照研究。数据由三名 BSC 护士和三名记卡员使用结构化核对表从患者病历中收集。然后将数据输入 Epi-data 3.1 版，并使用 SPSS 21 版进行分析。结果采用描述性统计（频率和百分比）。采用后向逐步法进行二元和多元逻辑回归分析。调整后的几率比（AOR）和 p 值 结果：共有 399 人（133 名患者和 266 名对照者）参与了这项研究。农村居民（AOR：3.46，95% CI：1.65，7.25）、男性患者（AOR：2.65，95% CI 1.54，4.55）、缺乏正规教育（AOR：4.35，95% CI 1.53，12.41）、基线 CD4 ≤350（AOR：5.25，95% CI 1.93，14.24）、功能状况不佳（AOR：4.298，95% CI 5.33,34.62）、WHO III 期和 IV 期（AOR：2.65，95% CI 1.68,4.19）以及结核合并感染（AOR：2.82，95% CI 1.11,7.45）是随访丧失的决定性因素：农村居民、男性、日工、未受过正规教育、基线 CD4 细胞数
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