INCIDENCE RATE AND ASSOCIATED FACTORS OF LOSS TO FOLLOW UP AMONG PATIENTS INITIATED ANTIRETROVIRAL THERAPY PROGRAM IN HIWOT FANA SPECIALIZED UNIVERSITY HOSPITAL, HARARA RETROSPECTIVE COHORT STUDY

Abstract

Background: The long-term survival of patients on antiretroviral treatment depends on lifetime adherence to antiretroviral therapy. Patients who are lost to follow-up while on treatment have been a challenge to carry out the antiretroviral therapy programmes effectively in terms of patient outcomes. Most studies in sub Saharan Africa have reported high rates of loss to follow up among patients enrolled in HIV care and treatment programmes. Few studies have been conducted among HIV infected patients in Hiwot Fana specialized university hospital, Harari region, Eastern Ethiopia. Objective: The aim of this study is to determine the incidence rate of loss to follow up and associated factors among human immunodeficiency virus infected patients attending in the antiretroviral clinic at Hiwot Fana Specialized university Hospital, Harari region, Eastern Ethiopia from February 1 to 28, 2018. Method: Kaplan Meier was used to estimate rates at particular times and generate a survival curve. Log Rank test was used to test the equality of survival probabilities and compared across the different groups of covariates and cox proportional hazards models to include additional covariates. Results: A total of 572 patients were contributed for 17,606 person months of follow up with a median survival time of event 13 months (IQR: 5-33). At the end of the study period 21% (95%CIs: 17.7, 24.4) of patients become LTFU giving a loss rate of 8.2 per 100 person years. Being male sex (Adjusted Hazard Ratio[AHR]= 2.10; 95% Confidence intervals [CIs]: 1.33, 3.30), Those patients who resided outside the region (AHR=2.14;95%CIs:1.37, 3.33), patients who are not disclosed their sero status (AHR=1.88;95%CIs:1.23, 2.89), being ambulatory or bedridden functional status (AHR=3.86;95%CIs:2.33, 6.38) and Tb/HIV co infection (AHR=3.45;95% CIs:2.23, 5.33) were significantly associated with loss to follow up in patients living with HIV/AIDS after initiation of anti-retro viral therapy. Conclusion and recommendations: The results of this cohort study reports a comparatively high rate of loss to follow up at Hiwot Fana specialized university hospital which may substantially affect the program outcome. Special attention should be given for male, residents outside the town, TB HIV co- infection, undisclosed and seriously ill patients at the early periods of anti-retro viral therapy enrollment.