Time to Loss to Follow-Up and Its Predictors among Adult Patients Receiving Antiretroviral Therapy at Aira General Hospital, Western Ethiopia

Download Article

DOI: 10.21522./TAJMHR.2016.05.02.Art021

Authors : Tesgera Jabessa Dinka, Dereje Tsegaye, Talkmore Maruti

Abstract:

The study aimed to assess the time to loss to follow-up and its predictors among HIV patients on ART at Aira General Hospital, Western Ethiopia. 2025. A retrospective cohort study was conducted on patients enrolled from January 2020 to December 2024 at Aira General Hospital. Data were analysed using Kaplan–Meier survival curves and Cox proportional hazard models. Variables with a p-value less than 0.05 in multivariate analysis were considered statistically significant. The incidence density rate of loss to follow-up (LTFU) from ART services among patients was 11.03 per 1,000 person-months (95% CI: 8.71, 13.96). Notably, 47 (67.14%) of the LTFU cases occurred within the first 12 months of treatment initiation. Several factors were significantly associated with LTFU in the multivariable analysis. Patients without a registered phone number (AHR = 4.16; 95% CI: 1.80–11.12), advanced WHO clinical stages (III and IV) (AHR = 2.78; 95% CI: 1.35–10.31), unknown viral load status (AHR = 3.81; 95% CI: 2.52–6.36), Non-disclosure of HIV status (AHR = 3.67; 95% CI: 1.56–7.21), lack of Cotrimoxazole preventive therapy (CPT) initiation (AHR = 3.22; 95% CI: 1.15–8.25), and poor or fair adherence to ART (AHR = 4.44; 95% CI: 1.73–10.12) were independent predictors of Loss To follow up. Loss to follow-up was highest within the first 12 months. Key predictors included lack of phone registration, advanced disease stages, non-disclosure, and poor adherence. Health providers should prioritize updating contact details, monitoring new patients, and assessing virological status regularly.

References:

[1].   Arnesen, R., Moll, A. P., Shenoi, S. V., 2017, Predictors of loss to follow-up among patients on ART at a rural hospital in KwaZulu-Natal, South Africa: PLoS One. 12 (5): e0177168.

[2].   Rashighi, M., Harris, J. E., 乳鼠心肌提取 HHS Public Access: Physiol Behav. 2017;176(3):139–48.

[3].   Kebede, H. K., Mwanri L., Ward P., Gesesew, H. A., 2021, Predictors of lost to follow up from antiretroviral therapy among adults in sub-Saharan Africa: a systematic review and meta-analysis. Infect Dis Poverty. 2021 Mar;10(1):33.

[4].   Tweya H., Oboho I.K., Gugsa S.T., Phiri S., Rambiki E., Banda R., et al., 2018, Loss to follow-up before and after initiation of antiretroviral therapy in HIV facilities in Lilongwe, Malawi: PLoS One. 13(1):e0188488.

[5].   Kiwanuka, J., Mukulu Waila, J., Muhindo Kahungu M., Kitonsa J., Kiwanuka N., 2020, Determinants of loss to follow-up among HIV positive patients receiving antiretroviral therapy in a test and treat setting: A retrospective cohort study in Masaka, Uganda. PLoS One. 15(4):e0217606.

[6].   Aliyu, A., Adelekan, B., Andrew, N., Ekong, E., Dapiap, S., Murtala-Ibrahim, F., et al., 2019, Predictors of loss to follow-up in art experienced patients in Nigeria: a 13 year review (2004-2017). AIDS Res Ther. 2019 Oct;16(1):30.

[7].   Fentie, D. T., Kassa, G. M., Tiruneh, S. A., Muche, A. A., 2022, Development and validation of a risk prediction model for lost to follow-up among adults on active antiretroviral therapy in Ethiopia: a retrospective follow-up study. BMC Infect Dis. 22(1):1–13.

[8].   Gebremichael, M. A., Gurara, M. K., Weldehawaryat, H. N., Mengesha, M. M., Berbada, D. A., 2021, Predictors of Loss to Follow-Up among HIV-Infected Adults after Initiation of the First-Line Antiretroviral Therapy at Arba Minch General Hospital, Southern Ethiopia: A 5-Year Retrospective Cohort Study. Biomed Res Int. 2021:8659372.

[9].   Megerso, A., Garoma, S., Eticha, T., Workineh, T., Daba, S, Tarekegn, M., et al., 2016, Predictors of loss to follow-up in antiretroviral treatment for adult patients in the Oromia region, Ethiopia: HIV AIDS (Auckl). 8:83–92.

[10].  Seifu, W., Ali, W., Meresa, B., 2018, Predictors of loss to follow up among adult clients attending antiretroviral treatment at Karamara general hospital, Jigjiga town, Eastern Ethiopia, 2015: a retrospective cohort study. BMC Infect Dis. 2018 Jun;18(1):280.

[11].  Telayneh, A. T., Tesfa, M., Woyraw, W., Temesgen, H., Alamirew, N. M., Haile, D., et al., 2022, Time to lost to follow-up and its predictors among adult patients receiving antiretroviral therapy retrospective follow-up study Amhara Northwest Ethiopia. Sci Rep., 12(1):2916.

[12].  Asiimwe, S. B., Kanyesigye, M., Bwana, B., Okello, S., Muyindike, W., 2016, Predictors of dropout from care among HIV-infected patients initiating antiretroviral therapy at a public sector HIV treatment clinic in sub-Saharan Africa. BMC Infect Dis., 16:43.

[13].  Gesesew, H. A., Ward, P., Hajito, K. W., Feyissa, G. T., Mohammadi, L., Mwanri, L., 2017, Discontinuation from Antiretroviral Therapy: A Continuing Challenge among Adults in HIV Care in Ethiopia: A Systematic Review and Meta-Analysis. PLoS One, 12(1):e0169651.

[14].  De La Mata, N. L., Ly, P. S., Nguyen, K. V., Merati, T. P., Pham, T. T., Lee, M. P., et al., 2017, Loss to Follow-up Trends in HIV-Positive Patients Receiving Antiretroviral Treatment in Asia From 2003 to 2013. J Acquir Immune Defic Syndr., 74(5):555–62.

[15].  Teshale, A. B., Tsegaye, A. T., Wolde, H. F., 2020, Incidence and predictors of loss to follow up among adult HIV patients on antiretroviral therapy in University of Gondar Comprehensive Specialized Hospital. PLoS One, 15(1):e0227473.

[16].  Assemie, M. A., Muchie, K. F., Ayele, T. A., 2018, Incidence and predictors of loss to follow up among HIV-infected adults at Pawi General Hospital, northwest Ethiopia: competing risk regression model. BMC Res Notes, 11(1):287.

[17].  Penn, A. W., Azman, H., Horvath, H., Taylor, K. D., Hickey, M. D., Rajan, J., et al., 2018, Supportive interventions to improve retention on ART in people with HIV in low- and middle-income countries: A systematic review. PLoS One, 13(12):1–16..

[18].  Shiferaw, W. S., Belete, A. M, Adela, A., Getnet, M., Aynalem, Y. A., 2022, Incidence and predictors of loss to follow-up among adult HIV-infected patients taking antiretroviral therapy at North Shewa zone public Hospitals, Northeast Ethiopia: A retrospective follow-up study. Afr Health Sci. 2022 Jun;22(2):12–26.

[19].  Organization, W.H., 2021, Consolidated guidelines on HIV prevention, testing, treatment, service delivery and monitoring: recommendations for a public health approach. Geneva: World Health Organization. p. 1–594.

[20].  Ntabanganyimana, D., Rugema, L., Omolo, J., Nsekuye, O., Malamba, S. S., 2022, Incidence and factors associated with being lost to follow-up among people living with HIV and receiving antiretroviral therapy in Nyarugenge the central business district of Kigali city, Rwanda: PLoS One, 17(10):1–14.

[21].  Dessu, S, Mesele, M., Habte, A., Dawit, Z., 2021, Time Until Loss to Follow-Up, Incidence, and Predictors Among Adults Taking ART at Public Hospitals in Southern Ethiopia: HIV AIDS (Auckl). 13:205–15.

[22].  Tesha, E. D, Kishimba, R., Njau, P., Revocutus, B., Mmbaga, E., 2022, Predictors of loss to follow up from antiretroviral therapy among adolescents with HIV/AIDS in Tanzania: PLoS One. 17(7):e0268825.

[23].  Birhanu, M. Y., Leshargie, C. T., Alebel, A., Wagnew, F., Siferih, M., Gebre, T., et al., 2020, Incidence and predictors of loss to follow-up among HIV-positive adults in northwest Ethiopia: a retrospective cohort study. Trop Med Health, 48:78.

[24].  Bain, L. E., Aboagye, R. G., Dowou, R. K., Kongnyuy, E. J., Memiah, P., Amu, H., 2022, Prevalence and determinants of maternal healthcare utilisation among young women in sub-Saharan Africa: cross-sectional analyses of demographic and health survey data. BMC Public Health, 22(1):1–20.