Wubshet Mamo, Berhane Yemane, Worku Alemayehu, Kebede Yigzaw, Diro Ermias
Institute of Public Health, University of Gondar, P.O. Box 196, Gondar, Ethiopia.
ISRN AIDS. 2012 Jun 14;2012:721720. doi: 10.5402/2012/721720. eCollection 2012.
Background. There has been a rapid scale up of antiretroviral therapy (ART) in Ethiopia since 2005. We aimed to evaluate mortality, loss to followup, and retention in care at HIV Clinic, University of Gondar Hospital, north-west Ethiopia. Method. A retrospective patient chart record analysis was performed on adult AIDS patients enrolled in the treatment program starting from 1 March 2005. We performed survival analysis to determine, mortality, loss to followup and retention in care. Results. A total of 3012 AIDS patients were enrolled in the ART Program between March 2005 and August 2010. At the end of the 66 months of the program initiation, 61.4% of the patients were retained on treatment, 10.4% died, and 31.4% were lost to followup. Fifty-six percent of the deaths and 46% of those lost to followup occurred in the first year of treatment. Male gender (adjusted hazard ratio (AHR) was 3.26; 95% CI: 2.19-4.88); CD4 count ≤200 cells/ μ L (AHR 5.02; 95% CI: 2.03-12.39), tuberculosis (AHR 2.91; 95% CI: 2.11-4.02); bed-ridden functional status (AHR 12.88; 95% CI: 8.19-20.26) were predictors of mortality, whereas only CD4 count <200 cells/ μ L (HR = 1.33; 95% CI: (0.95, 1.88) and ambulatory functional status (HR = 1.65; 95% CI: (1.22, 2.23) were significantly associated with LTF. Conclusion. Loss to followup and mortality in the first year following enrollment remain a challenge for retention of patients in care. Strengthening patient monitoring can improve patient retention AIDS care.
背景。自2005年以来，埃塞俄比亚抗逆转录病毒疗法（ART）的规模迅速扩大。我们旨在评估埃塞俄比亚西北部贡德尔大学医院艾滋病毒诊所的死亡率、失访情况及治疗留存率。方法。对2005年3月1日起纳入治疗项目的成年艾滋病患者进行回顾性病历记录分析。我们进行生存分析以确定死亡率、失访情况及治疗留存率。结果。2005年3月至2010年8月期间，共有3012名艾滋病患者纳入ART项目。在项目启动66个月结束时，61.4%的患者持续接受治疗，10.4%死亡，31.4%失访。56%的死亡病例和46%的失访病例发生在治疗的第一年。男性（调整后风险比（AHR）为3.26；95%置信区间：2.19 - 4.88）；CD4细胞计数≤200个/μL（AHR 5.02；95%置信区间：2.03 - 12.39），结核病（AHR 2.91；95%置信区间：2.11 - 4.02）；卧床功能状态（AHR 12.88；95%置信区间：8.19 - 20.26）是死亡率的预测因素，而只有CD4细胞计数<200个/μL（HR = 1.33；95%置信区间：(0.95, 1.88)）和非卧床功能状态（HR = 1.65；95%置信区间：(1.22, 2.23)）与失访显著相关。结论。入组后第一年的失访和死亡率仍是患者治疗留存的挑战。加强患者监测可提高艾滋病治疗的患者留存率。
