乌干达阿朱马尼区接受治疗的南苏丹艾滋病毒难民失访的发生率及预测因素。

Incidence and predictors of loss to follow-up among South Sudanese refugees with HIV receiving care in Adjumani District, Uganda.

作者信息

Nyolonga Christopher, Ufoyrwoth Joshua Uchaki, Wanok Trinity, Komakech David, Baluku Joseph Baruch, Bongomin Felix

机构信息

Department of Medical Microbiology and Immunology, Faculty of Medicine, Gulu University, Gulu, Uganda.

Division of Pulmonology, Directorate of Internal Medicine, Kiruddu National Referral Hospital, Kampala, Uganda.

出版信息

IJID Reg. 2025 Apr 22;15:100653. doi: 10.1016/j.ijregi.2025.100653. eCollection 2025 Jun.

DOI:10.1016/j.ijregi.2025.100653

PMID:40475093

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12138943/

Abstract

OBJECTIVES

HIV care pose a significant challenge in refugee population. We determined the incidence and predictors of loss to follow-up (LTFU) among South Sudanese refugees with HIV in Uganda.

METHODS

We conducted a retrospective cohort study in public health facilities in Adjumani District, Uganda, involving South Sudanese refugees with HIV. LTFU was defined as missing 3 or more consecutive months at any point in their care since the start of the study period. A Cox proportional hazards regression analysis was fitted to determine independent predictors of LTFU and results are presented as adjusted hazard ratios (aHRs) with corresponding 95% confidence intervals (CIs).

RESULTS

We included data of 449 participants, with a median age of 37 (interquartile range: 30-43) years. Most were female patients (75.5%, n = 339) receiving care from health center (HC) III (87.3%, n = 392), with baseline World Health Organization stage 1 (79.3%, n = 341), negative baseline tuberculosis status (89.1%, n = 302), and suppressed viral load (86.5%, n = 360) and had no co-morbidity (91%, n = 402). Overall, 25 (5.6%) were lost to follow-up. Factors independently associated with LTFU were being male (aHR: 2.6, 95% CI: 1.1-6.1, = 0.03) and receiving care from HC IV (aHR: 3.0, 95% CI: 1.0-8.8, = 0.04).

CONCLUSIONS

LTFU among South Sudanese refugees with HIV in Uganda is substantial. Routine use of patient address locator forms, and improved quality of HIV care at HC IV and men-targeted outreaches and community involvement may reduce LTFU among refugees living with HIV.

摘要

目的

在难民群体中，艾滋病毒护理是一项重大挑战。我们确定了乌干达感染艾滋病毒的南苏丹难民失访（LTFU）的发生率及预测因素。

方法

我们在乌干达阿朱马尼区的公共卫生机构开展了一项回顾性队列研究，研究对象为感染艾滋病毒的南苏丹难民。自研究期开始以来，失访被定义为在其护理过程中的任何时间连续3个月或更长时间未接受治疗。采用Cox比例风险回归分析来确定失访的独立预测因素，结果以调整后的风险比（aHRs）及相应的95%置信区间（CIs）呈现。

结果

我们纳入了449名参与者的数据，中位年龄为37岁（四分位间距：30 - 43岁）。大多数为女性患者（75.5%，n = 339），在卫生中心（HC）III接受护理（87.3%，n = 392），基线时处于世界卫生组织第1阶段（79.3%，n = 341），基线结核状态为阴性（89.1%，n = 302），病毒载量得到抑制（86.5%，n = 360），且无合并症（91%，n = 402）。总体而言，25人（5.6%）失访。与失访独立相关的因素为男性（aHR：2.6，95% CI：1.1 - 6.1，P = 0.03）以及在HC IV接受护理（aHR：3.0，95% CI：1.0 - 8.8，P = 0.04）。