Predictors Of Loss To Follow Up Among Clients Attending Art Clinic Of Jimma University Specialized Hospital, South West Ethiopia, August 201

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