确定加纳一个高负担地区感染艾滋病毒的成年人失访的风险因素。

Identifying risk factors for loss to follow-up in adults living with HIV in a high-burden district in Ghana.

作者信息

Mensah Benedicta Ayiedu, Mensah-Brown Henrietta E, Partey Frederica D, Addo Christabel, Buah Gertrude, Afudego Gifty A, Okyere Daniel, Tetteh Mary, Boateng Ernest, Wilson Michael, Paintsil Elijah

机构信息

Department of Epidemiology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana.

West African Center for Cell Biology of Infectious Pathogens, University of Ghana, Legon, Accra, Ghana.

出版信息

BMC Public Health. 2025 Mar 18;25(1):1042. doi: 10.1186/s12889-025-22254-w.

DOI:10.1186/s12889-025-22254-w

PMID:40102895

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11917097/

Abstract

BACKGROUND

Loss to follow-up (LTFU) in the care of persons living with HIV hinders the effectiveness of treatment strategies and undermines global health initiatives to achieve targets such as the 95-95-95 goals. Identifying risk factors for LTFU will help develop effective interventions that enhance long-term outcomes for people living with HIV (PLWHIV). Thus, this study aimed to explore the risk factors influencing LTFU among PLWHIV in a high-burden district in Ghana.

METHODS

A retrospective analysis was conducted using medical records of 401 patients who initiated Antiretroviral Therapy (ART) between January 1st, 2011, and December 31st, 2021, in a high-burden district in Ghana and data extraction period of January to December 2022. We defined LTFU as a failure of a patient to return to the HIV clinic for at least 30, 90, 180, and 270 days from the date of their last appointment. A logistic regression model was utilized to determine the risk factors associated with LTFU.

RESULTS

Out of 401 records reviewed, 298 (74%) were females. The proportions of individuals LTFU were 46%, 26%, and 15% for 90 days, 180 days, and 270 days, respectively. Additionally, only 14% of patients achieved the required four or more hospital visits within the last year of the review. Education was a risk factor associated with LTFU, with individuals with primary education (aOR = 0.32, 95% CI: 0.15, 0.66) and senior high school or higher education (aOR = 0.51, 95% CI: 0.27, 0.99) having lower odds of LTFU compared to those with no education. The duration of HIV care was also associated with LTFU. Patients who were in care for less than or equal to five years were more likely to be LTFU compared to those in care for more than five years. None of the clinical variables were associated with loss to follow-up.

CONCLUSION

Our study provides new information about LTFU and its associated risk factors in Ghana. These findings underscore the need to promote health literacy in the fight against HIV/AIDS in Ghana.

摘要

背景

艾滋病毒感染者护理中的失访情况阻碍了治疗策略的有效性，并破坏了实现95-95-95目标等全球卫生倡议。确定失访的风险因素将有助于制定有效的干预措施，以改善艾滋病毒感染者（PLWHIV）的长期治疗效果。因此，本研究旨在探讨加纳一个高负担地区艾滋病毒感染者失访的影响因素。

方法

利用2011年1月1日至2021年12月31日期间在加纳一个高负担地区开始接受抗逆转录病毒治疗（ART）的401例患者的病历进行回顾性分析，并于2022年1月至12月进行数据提取。我们将失访定义为患者自上次就诊之日起至少30天、90天、180天和270天未返回艾滋病毒诊所。采用逻辑回归模型确定与失访相关的风险因素。

结果

在审查的401份记录中，298例（74%）为女性。90天、180天和270天失访的患者比例分别为46%、26%和15%。此外，在审查的最后一年中，只有14%的患者达到了所需的四次或更多次医院就诊。教育程度是与失访相关的风险因素，与未受过教育的人相比，小学教育程度（调整后比值比[aOR]=0.32，95%置信区间[CI]：0.15，0.66）和高中及以上教育程度（aOR=0.51，95%CI：0.27，0.99）的人失访几率较低。艾滋病毒护理的持续时间也与失访有关。与接受护理超过五年的患者相比，接受护理少于或等于五年的患者更有可能失访。没有任何临床变量与失访相关。