Zeleke Shegaw, Demis Solomon, Eshetie Yeshiambaw, Kefale Demewoz, Tesfahun Yohannes, Munye Tigabu, Kassaw Amare
Department of Adult Health Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia.
Department of Maternity and Neonatal Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia.
J Multidiscip Healthc. 2023 Jun 22;16:1737-1748. doi: 10.2147/JMDH.S414194. eCollection 2023.
Approximately 38.4 million adult people worldwide live with HIV, of which the majority live in Africa. In Ethiopia increasing the quality of life to HIV patients and preventing HIV transmission are challenging. Even though test-and-treat strategy is applied for early enrollment to ART, poor retention and loss to follow-up are hindering the care.
This study examined the incidence and predictors of loss to follow-up among adult HIV patients on ART in South Gondar governmental hospitals, September 11, 2017-September 10, 2022.
A multi-facility-based retrospective follow-up study was conducted. Study subjects were assigned using simple random sampling methods by their medical record numbers. The data were entered into EPI data version 3.0.2 and exported to STATA version 17 for analysis. The Kaplan-Meier failure function was employed to determine the overall failure estimates. Cox proportional hazard model was tailored for both bi-variable and multivariable. Variables at -value <0.05 with 95% CI were significantly associated with loss to follow-up.
In this study, about 559 adult HIV survivors were included, and the response rate was 98%. The mean age and standard deviation (±SD) of study subjects were 36.6±9.3 years. The incidence rate of loss to follow-up was 6.7 per 100 person-years (95% CI: 5.6, 8.1). Educational status [AHR: 1.68 (95% CI: 1.04, 2.72)], substance use [AHR: 2.38 (95% CI: 1.50, 3.75)], and ART adherence [AHR: 3.33 (95% CI: 1.38, 8.08)] were significant determinants to loss to follow-up.
In conclusion, the study finding reported that the incidence of loss to follow-up was low. HIV patients who did not have formal education, substance users, and poor ART adherence were at greater hazard of being lost to follow-up. In order to mitigate the rate of loss to follow-up, it is recommended to strengthen the available intervention modalities.
全球约有3840万成年人感染艾滋病毒，其中大多数生活在非洲。在埃塞俄比亚，提高艾滋病毒患者的生活质量和预防艾滋病毒传播具有挑战性。尽管采用了检测即治疗策略以尽早纳入抗逆转录病毒治疗（ART），但依从性差和失访问题阻碍了治疗。
本研究调查了2017年9月11日至2022年9月10日期间，南贡德尔政府医院接受抗逆转录病毒治疗的成年艾滋病毒患者的失访发生率及预测因素。
进行了一项基于多机构的回顾性随访研究。通过简单随机抽样方法，根据病历号分配研究对象。数据录入EPI数据3.0.2版本，并导出到STATA 17版本进行分析。采用Kaplan-Meier失败函数确定总体失败估计值。Cox比例风险模型用于单变量和多变量分析。P值<0.05且95%置信区间的变量与失访显著相关。
本研究纳入了约559名成年艾滋病毒幸存者，应答率为98%。研究对象的平均年龄和标准差（±SD）为36.6±9.3岁。失访发生率为每100人年6.7例（95%置信区间：5.6，8.1）。教育程度[AHR：1.68（95%置信区间：1.04，2.72）]、药物使用[AHR：2.38（95%置信区间：1.50，3.75）]和抗逆转录病毒治疗依从性[AHR：3.33（95%置信区间：1.38，8.08）]是失访的重要决定因素。
总之，研究结果表明失访发生率较低。未接受正规教育的艾滋病毒患者、药物使用者和抗逆转录病毒治疗依从性差的患者失访风险更高。为了降低失访率，建议加强现有的干预措施。
