Moderate incidence of lost follow-up and risk factors among adult HIV patients on second-line ART regimens in Amhara region hospitals, Ethiopia

  • Ahmed Mohammed Department of Public Health, College of Medicine and Health Sciences, Jijiga University, Ethiopia
  • Saed Abdi Department of Nursing, College of Medicine and Health Sciences, Jijiga University, Ethiopia
  • S Palani School of Medicine, College of Medicine and Health Sciences, Jijiga University, Ethiopia
  • Nisha Mary Joseph School of Pharmacy, College of Health Sciences, Addis Ababa University, Ethiopia

Abstract

Background and Objectives: Loss to follow-up is a common problem of most patients on antiretroviral therapy in Ethiopia. Second-line antiretroviral therapy is the drug that would be used when the first-line therapy fails.  Thus this study intends to determine the incidence and risk factors of time to losses to follow up among  Human  Immunodeficiency  Virus (HIV) patients on second line regimens of  Antiretroviral Therapy(ART) in Amhara region Hospitals, Ethiopia.


Methods: Institutional based retrospective cohort study was conducted in the Amhara region hospitals from February to March 2016. A total of 1246 patient from eight hospitals in Amhara region were selected using simple random sampling method and data were extracted from patient charts.  The log rank test was used to assess presence of significant difference in time to losses to follow among levels of categorical variables. Both bi-variiable and multivariable Cox proportional hazards models were used to identify factors that affect the time to losses to follow up.   


Results: The cumulative incidence of loss to follow up was 5.41% over the entire (eight) years of follow-up. The cumulative incidence rates of death and transfer out were 10.99%,10.02 %, respectively. In multivariable Cox regression analysis, ambulatory functional status (AHR=0.1967, 95% CI: 0.049- 0 .794), male gender (AHR=2.135, 95% CI: 1.053- 4.330),  adherence to ART (AHR=0.442, 95% CI: 0.198- 0.989) were significant predictors of time to losses to follow up. The use of 2a, 2e and 2g types of second line regimen reduced the risk of  loss to follow up.


Interpretations and Conclusions: The incidence of loss to follow up in Amhara region hospitals was low. Loss to folow up was negatively  associated with female gender, ambulatory  baseline functional status, adherence, & types of second line regimen types. Further research on the effect of  types of drug is recommended by acertaining whether the reduction in loss to follow up  for patients who took drug types of 2a, 2e, and 2g is associaed with improved or worsened health outcomes by trafcking lost patients closely.  

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Author Biographies

Ahmed Mohammed, Department of Public Health, College of Medicine and Health Sciences, Jijiga University, Ethiopia

Department of Public Health, College of Medicine and Health Sciences, Jijiga University, Ethiopia

Saed Abdi, Department of Nursing, College of Medicine and Health Sciences, Jijiga University, Ethiopia

Department of Nursing, College of Medicine and Health Sciences, Jijiga University, Ethiopia

S Palani, School of Medicine, College of Medicine and Health Sciences, Jijiga University, Ethiopia

School of Medicine, College of Medicine and Health Sciences, Jijiga University, Ethiopia

Nisha Mary Joseph, School of Pharmacy, College of Health Sciences, Addis Ababa University, Ethiopia

School of Pharmacy, College of Health Sciences, Addis Ababa University, Ethiopia

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How to Cite
Mohammed, A., Abdi, S., Palani, S., & Joseph, N. M. (2019). Moderate incidence of lost follow-up and risk factors among adult HIV patients on second-line ART regimens in Amhara region hospitals, Ethiopia. Journal of Drug Delivery and Therapeutics, 9(1-s), 52-59. https://doi.org/10.22270/jddt.v9i1-s.2253