埃塞俄比亚奥罗米亚南部接受抗逆转录病毒治疗的感染艾滋病毒儿童的失访情况及其预测因素：一项5年回顾性队列研究

Loss to follow-up and its predictors among children living with HIV on antiretroviral therapy, southern Oromia, Ethiopia: a 5-year retrospective cohort study.

作者信息

Bankere Assefa Washo, Daba Sintayehu Gabisa, Ami Bonso, Gedefa Lalisa Kebebe, Lencha Bikila

机构信息

Department of Public Health, Hawassa College of Health Science, Hawassa, Ethiopia

Department of Disease Prevention and Control, Oromia Regional Health Bureau, Bishoftu, Addis Ababa, Ethiopia.

出版信息

BMJ Open. 2024 Jul 31;14(7):e078370. doi: 10.1136/bmjopen-2023-078370.

DOI:10.1136/bmjopen-2023-078370

PMID:39089715

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11293378/

Abstract

BACKGROUND

Loss to follow-up (LTFU) among paediatric patients living with HIV presents a significant challenge to the global scale-up of life-saving antiretroviral therapy (ART).

OBJECTIVES

This study aims to estimate LTFU incidence and its determinants among children with HIV on ART in Shashemene town public health institutions, Oromia, Ethiopia.

DESIGN

A retrospective cohort study from 1 January 2015 to 30 December 2020.

SETTING

This study was conducted in Shashemene town, Oromia, Ethiopia.

PARTICIPANTS

Medical records of 269 children receiving ART at health facilities in Shashemene town were included.

METHODS

Data from patients' medical records were collected using a standardised checklist. EpiData V.3.1 was employed for data entry, while Statistical Package for the Social Sciences (SPSS) V.25 facilitated analysis. The Kaplan-Meier survival curve was used for estimation of survival time. To measure association, adjusted HRs (AHRs) with 95% CIs were calculated. Both bivariable and multivariable Cox proportional hazards regression models were employed to identify predictors of LTFU.

RESULTS

Of the 269 children living with HIV included in the final analysis, 43 (16%) were lost to follow-up. The overall incidence rate of LTFU was 3.3 (95% CI 2.4 to 4.4) per 100 child-years of observation. Age less than 5 years (AHR 0.03, 95% CI 0.00 to 0.36), non-orphan status of the child (AHR 0.13, 95% CI 0.05 to 0.34), < 30 min distance to health facility (AHR 0.24, 95% CI 0.08 to 0.73), disclosed HIV status (AHR 0. 32, 95% CI 0.13 to 0.80), history of opportunistic infection (AHR 3.54, 95% CI 1.15 to 10.87) and low CD4 count (AHR 5.17, 95% CI 2.08 to 12.85) were significant predictors of LTFU.

CONCLUSION

The incidence rate of LTFU was lower compared with other studies in Ethiopia. This result indicated that age less than 5 years, non-orphans, low CD4, disclosed HIV status and distance from health facility were predictors of LTFU.

摘要

背景

感染艾滋病毒的儿科患者失访对全球扩大挽救生命的抗逆转录病毒疗法（ART）构成重大挑战。

目的

本研究旨在估计埃塞俄比亚奥罗米亚州沙舍梅内镇公共卫生机构中接受抗逆转录病毒治疗的艾滋病毒感染儿童的失访发生率及其决定因素。

设计

一项2015年1月1日至2020年12月31日的回顾性队列研究。

地点

本研究在埃塞俄比亚奥罗米亚州沙舍梅内镇进行。

参与者

纳入了沙舍梅内镇医疗机构中269名接受抗逆转录病毒治疗儿童的病历。

方法

使用标准化清单收集患者病历中的数据。采用EpiData V.3.1进行数据录入，而社会科学统计软件包（SPSS）V.25便于进行分析。采用Kaplan-Meier生存曲线估计生存时间。为衡量关联性，计算了调整后的风险比（AHRs）及95%置信区间（CIs）。采用双变量和多变量Cox比例风险回归模型来确定失访的预测因素。

结果

最终分析纳入的269名感染艾滋病毒的儿童中，43名（16%）失访。每100儿童年观察期的失访总发生率为3.3（95%CI 2.4至4.4）。年龄小于5岁（AHR 0.03，95%CI 0.00至0.36）、儿童非孤儿身份（AHR 0.13，95%CI 0.05至0.34）、距离医疗机构<30分钟路程（AHR 0.24，95%CI 0.08至0.73）、公开的艾滋病毒感染状况（AHR 0.32，95%CI 0.13至0.80）、机会性感染史（AHR 3.54，95%CI 1.15至10.87）和低CD4计数（AHR 5.17，95%CI 2.08至12.85）是失访的显著预测因素。