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Time Until Loss to Follow-Up, Incidence, and Predictors Among Adults Taking ART at Public Hospitals in Southern Ethiopia

Authors Dessu S, Mesele M, Habte A, Dawit Z

Received 8 December 2020

Accepted for publication 29 January 2021

Published 17 February 2021 Volume 2021:13 Pages 205—215


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Professor Bassel Sawaya

Samuel Dessu,1 Molalegn Mesele,2 Aklilu Habte,3 Zinabu Dawit4

1Department of Public Health, College of Medicine and Health Sciences, Wolkite University, Wolkite, Southern Ethiopia, Ethiopia; 2Department of Midwifery, College of Medicine and Health Sciences, Wolaita Soddo University, Wolaita, Southern Ethiopia, Ethiopia; 3Department of Public Health, College of Medicine and Health Sciences, Wachamo University, Hossana, Southern Ethiopia, Ethiopia; 4Department of Nursing, Arba Minch Health Science College, Arba Minch, Southern Ethiopia, Ethiopia

Correspondence: Samuel Dessu
Department of Public Health, College of Medicine and Health Sciences, Wolkite University, Wolkite, Southern Ethiopia, Ethiopia
Tel +251 910883594

Introduction: According to the World Health Organization, more than seventeen million people were accessing ART in 2015 globally. Adherence to effective ART reduced the risk of transmitting the virus to uninfected persons. The government and other stakeholders’ focus was high to reduce the rate of loss to follow-up in HIV programs among patients who are already on ART follow-up, but its incidence rate increases from time to time.
Methods: A retrospective cohort study was conducted among the records enrolled from 1 January 2013 to 30 December 2017 at Public hospitals in Southern Ethiopia. Data were entered into Epi info V 7 and exported to STATA V 14 for analysis. The Kaplan–Meier survival curve together with a log rank test was used to estimate the survival time of the ART attending patients. Variables which had p-value < 0.05 in multivariable analysis using the cox proportional hazard model were declared as statistically significant.
Results: The incidence rate of loss to follow-up from ART services among adults attending ART was 6.48 (95% CI:5.67,7.29) per 1000 person months. The cumulative survival probability at the end of the 10th, 20th, 40th and 60th follow-up month was 0.89 (95% CI:0.87,0.91), 0.82 (95% CI:0.79,0.85), 0.78 (95% CI:0.75,0.81) and 0.74 (95% CI:0.70,0.77), respectively. Distance > 5 kilometers (AHR:3.71; 95% CI:2.32,5.95), not having registered phone number (AHR:2.52; 95% CI:1.76,3.60), not initiating Isoniazid (AHR:2.15; 95% CI:1.50,3.08), body mass index < 18.50kg/m2 (AHR:1.87; 95% CI: 1.18; 2.97) and not having primary caregiver (AHR: 2.59; 95% CI: 1.84, 3.66) were statistically significant predictors of loss to follow-up.
Conclusion: The time until loss to follow-up was high in the first 20 months of the initiation of the ART and it declines after 20 months; longer distance between home and hospital, not having registered phone number, not initiating INH, lower body mass index and not having primary caregiver were the independent predictors of loss to follow-up from ART services.

Keywords: loss to follow-up, incidence, survival time, predictor, ART

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