Abstract:
Background: In spite of the well proven benefits of antiretroviral therapy in prolonging the life
expectancy and improving the quality of life of people living with HIV/AIDS, loss to ART followup are a problem to the success of ART programs in resource limited countries. In Ethiopia, even
though ART and related medical services have been given free of charge since 2005 as part of
the global ART scale-up initiatives, loss to ART follow-up has become one of the challenges
facing the program.
Objective: The objective of this study was to assess the prevalence and predictors for lost to
follow up from antiretroviral treatment (ART) among client attending ART clinic in Jimma
university specialized hospital, Ethiopia
Methods: A retrospective cohort study was conducted among PLWHA started ART from January
2008 to December 2012 in Jimma university specialized hospital with in the period of Apr10 to
may 10/2013 . Survival analysis was performed to determined, loss to follow-up. Two nurses and
case managers of the chronic care clinic collected the data. A checklist which was developed
using the standardized ART entry and follow up form adopted from Ministry of Health was used
as instrument. The data were coded and entered to Epi data version 3.1 then it was exported to
SPSS version 16.0 for descriptive and analytic data analysis. For descriptive statistics such as
median, mean and SDs were used to investigate the characteristics of the cohort. For analytic
statistic Cox regression and Kaplan-Meier analyses were performed to investigate factors that
influence time to lost follow up.
Result: A total of 2182 PLWHA were involved in this cohort. The prevalence of lost to follow up
among PLWHA in jimma university specialize hospital was 15.4%. The mean age of the
participants was 31.94 + 8.46 years. Those who have concern about their HIV status disclosure
accounted for 58.9%. Significant predictors identified for lost to follow up were being protestant
(HR 0.607 CI 0.386-0.95), past TB test negative(HR 0.443, 95%CI 0.312-0.630), discloser
concern (HR, 2.22 95%CI 1.72-2.87), absence of stigma (HR 0.61, 95%ci 0.479-0.78), WHO
clinical stage II (HR 1.39, 95%ci 1.01- 1.92), WHO clinical stage III (HR 1.62, 95% CI 1.2-
2.18) and CD4 blow 200(HR 1.41, 95% CI 1.01- 1.84)
Conclusion and recommendation: The prevalence of lost to follow up was 15.4 %. Religion,
past TB test, ART adherence barriers, WHO clinical stage, residence and CD4 blow 200, are
significant predictors of lost to follow up. In addition to the routine care health care providers
should give special emphasis for those PLWHA coming from rural area
