Megerso Abebe, Garoma Sileshi, Eticha Tolosa, Workineh Tilaye, Daba Shallo, Tarekegn Mihretu, Habtamu Zelalem
Department of Public Health, Adama Hospital Medical College, Addis Ababa, Ethiopia.
Department of Pediatrics and Child Health, Adama Hospital Medical College, Addis Ababa, Ethiopia.
HIV AIDS (Auckl). 2016 Apr 26;8:83-92. doi: 10.2147/HIV.S98137. eCollection 2016.
PURPOSE: It is known that antiretroviral treatment (ART) reduces mortality from acquired immunodeficiency syndrome related causes. Patient's lost to follow-up (LTFU) in this treatment poses a paramount problem to the public and health care services. Information on predictors of loss to follow-up is scarce in this study area and similar settings. Therefore, this study aimed at identifying correlates of loss to follow-up in ART among adult patients in the Oromia region of Ethiopia. METHODS: A case-control study was conducted between February 2015 and April 2015 using medical records. The stratified sampling technique was used to select health facilities. The number of patient records to be included in the study was proportionally allocated to each stratum based on their patient proportion in the regional data. Specific health facilities from which to include the records were randomly selected from a list of the health facilities per stratum. All adult patient records registered as LTFU (416) in the selected health facilities during the 12-month period prior to the data collection date, and 832 patients with good adherence to ART were included. Data were double-entered into Epi Info 7 and analyzed using SPSS 20. Descriptive statistics and binary logistic regression were used to report the results. Qualitative data were thematically analyzed using open code computer software. RESULTS: Age 15-24 years (adjusted odds ratio [AOR], 19.82 95% CI: 6.80, 57.73); day laborers (AOR, 5.36; 95% confidence interval [CI]: 3.23, 8.89), rural residents (AOR, 2.35; 95% CI: 1.45, 3.89), World Health Organization clinical stage IV (AOR, 2.29; 95% CI: 1.45, 3.62), baseline CD4 <350 cells/mL (AOR, 2.06; 95% CI: 1.36, 3.13), suboptimal adherence to ART (AOR, 7.42; 95% CI: 1.87, 29.41), were factors which increased the risk of loss to follow-up in ART. CONCLUSION: Multiple risk factors, both socioeconomic and clinical, were associated with loss to follow-up. Attention is required to address these factors during patient preparation for the treatment and follow-up counseling by practitioners. We recommend that other studies identify what happened to the patients registered as LTFU as the current study could not address this issue.
目的：众所周知，抗逆转录病毒治疗（ART）可降低获得性免疫缺陷综合征相关病因导致的死亡率。接受该治疗的患者失访对公众和医疗服务构成了一个至关重要的问题。在本研究领域及类似环境中，关于失访预测因素的信息匮乏。因此，本研究旨在确定埃塞俄比亚奥罗米亚地区成年患者接受抗逆转录病毒治疗时失访的相关因素。 方法：2015年2月至2015年4月间利用病历进行了一项病例对照研究。采用分层抽样技术选择卫生机构。根据各层在区域数据中的患者比例，按比例将纳入研究的患者记录数量分配到每个层。从每层卫生机构列表中随机选择要纳入记录的特定卫生机构。在数据收集日期前12个月期间，所选卫生机构中登记为失访的所有成年患者记录（416份）以及832名抗逆转录病毒治疗依从性良好的患者被纳入研究。数据双录入Epi Info 7并使用SPSS 20进行分析。采用描述性统计和二元逻辑回归报告结果。定性数据使用开放编码计算机软件进行主题分析。 结果：年龄15 - 24岁（调整优势比[AOR]，19.82；95%置信区间[CI]：6.80，57.73）；日工（AOR，5.36；95%置信区间[CI]：3.23，8.89），农村居民（AOR，2.35；95% CI：1.45，3.89），世界卫生组织临床分期IV期（AOR，2.29；95% CI：1.45，3.62），基线CD4<350个细胞/毫升（AOR，2.06；95% CI：1.36，3.13），抗逆转录病毒治疗依从性欠佳（AOR，7.42；95% CI：1.87，29.41），是增加抗逆转录病毒治疗失访风险的因素。 结论：社会经济和临床方面的多种风险因素与失访相关。从业者在患者治疗准备和随访咨询过程中需要关注这些因素。我们建议其他研究确定登记为失访的患者情况，因为本研究未能解决这一问题。
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