INCIDENCE AND PREDICTORS OF LOSS TO FOLLOW-UP AMONG ADULT PATIENTS RECEIVING ANTI-RETROVIRAL THERAPY IN KEMBATA TEMBARO ZONE PUBLIC HOSPITALS, SOUTHRN ETHIOPIA: A RETROSPECTIVE COHORT STUDY

Abstract

Background; Human Immunodeficiency Virus (HIV) is one of the global public health issue. Nearly 37.7 million people were suffered from HIV/AIDS worldwide. Accesses of free antiretroviral therapy services reduce transmission, morbidity and mortality significantly. However, loss to follow-up is a major factor that negatively affects the benefit of ART. Objective: To assess the incidence and predictors of loss to follow-up among adult HIV- positive patients receiving antiretroviral therapy in the Kembata Tembaro zone public Hospitals. Methods: An institution-based retrospective cohort study was carried out and data were collected from 432 patients’ charts by using a systematic random sampling technique. All statistical analyses were conducted using Stata version 14. Cumulative survival probability was applied to estimated and presented in the life table, and the Kaplan-Meir survival curves by using the log rank test to compare the probability of survival among different groups. The Cox proportional hazard model was used to identify the independents predictors of loss to follow-up. Results Over all incidence rate of loss to follow-up was 8.12(95% CI: 7.11, 9.09) per 1000 person-month. In multivariate cox regression analysis; not disclose HIV status (AHR=1.94, 95% CI: 1.14, 3.36), Ambulatory functional status (AHR=1.84, 95%CI: 1.13, 2.22), have Opportunistic infections (AHR=3.13,95%CI :2.17,4.52), CD4 count less than 200cell/mm3 (AHR=1.95,95% CI:1.18, 3.21), not receiving isoniazid preventive therapy (AHR =2.57, 95% CI:1.62,4.06),not participate in associations/clubs (AHR=1.68,95%CI:1.10,2.22),have drug side effect (AHR=1.44 95% CI: 1.02, 2.04) and high viral load (AHR=3.15,95%CI:1.81,5.47) were significant predictors of LTFU. Conclusions xii This study suggests that, the overall incidence rate of loss to follow-up in adults receiving ART patients were high. Loss to follow-up occurred mostly in patients not disclose HIV status, ambulatory functional status, CD4 count less than 200cell/ mm3, not participate in club, have OI, not receive IPT, viral load greater than 1000 copies per ml and those develop drug related side effect were significant predictors of loss to follow-up.