Loss To Follow-up And Its Predictors Among Adult Hiv Patients On Rapid Initiation Of Antiretroviral Treatment In Selected Governmental Hospitals Southwest Ethiopia 2019

Background: Currently, lifelong anti-retroviral treatment were given for people living withrnHIV without considering their CD4 cell counts & WHO clinical staging in most countries ofrnthe World including Ethiopia. Even if there were no sufficient evidence on loss to follow uprnafter the implementation of rapid initiation of anti retroviral treatment in Ethiopia, studiesrnshowed that rapid initiation of ART will increase the risk of loss to follow up especially in lowrnlevel income countries. rnObjective: The aim of this study was to assess loss to follow up and its predictors amongrnadult HIV infected patients on rapid initiation of anti retroviral treatment in GebretsadikrnShawo General Hospital and Mizan-Tepi University Teaching Hospital. rnMethods: Retrospective cohort study design was used to assess loss to follow up and itsrnpredictors among adult HIV infected patients on rapid initiation of anti retroviral treatment inrnGebretsadik Shawo General Hospital and Mizan-Tepi University Teaching Hospital fromrnOctober 2017 to December 31, 2018. A total of 318 patients card were retrieved by usingrnchecklists developed to assess loss to follow up from anti retroviral therapy clinics. Data wererncollected from March 20 through April 15, 2019, entered into Epi data 3.1 and exported tornstatistical package for social sciences (SPSS) version 24. Kaplan–Meier curve and log-rankrntest were used to compare survival experiences. Cox-regression was used to identify thernpredictors of loss to follow up at p≤ 0.05. rnResult: All the 318 patients were followed for 2662 person-months and the overall incidence rate ofrnloss to follow up were 3.5 per 100 person months (95% CI: 2.8, 4.2). Being male sex (AHR =4.33; rn95%CI: 2.22, 8.43), unknown IPT status (AHR=5.49; 95%CI: 1.46, 20.59), not received IPTrnhistory (AHR=2.42; 95% CI: 1.49, 3.91), bedridden functional status (AHR=5.049; 95% CI:rn2.34, 10.87) and non disclosures (AHR=2.28; 95% CI: 1.35, 3.83) were identified asrnindependent predictors of time to LTFU.rnConclusion: high proportion of loss to follow up was recorded especially on the same dayrntreatment. Therefore, proper counseling and tracing mechanisms were recommended forrnhighly risky patients for loss to follow up.

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