Incidence And Predictors Of Loss To Follow-Up Among Adult Patients Receiving Anti-Retroviral Therapy At Health Centers In Addisketema Sub City, Addis Ababa, Ethiopia 2024

Abstract

Background: Human Immunodeficiency Virus which potentially leads to Acquired Immune Deficiency Syndrome is a global health problem. In 2022 alone, an estimated 39 million individuals battled the virus. Loss to follow-up which is defined as the absence of an Antiretroviral therapy refill or follow-up for three months or more after the last follow-up. Loss to follow-up has significant social and economic consequences, including stigma, vulnerability to mental health issues, and decreased productivity. Objective: To assess the incidence and predictors of loss to follow-up among adult patients receiving anti-retroviral therapy at government health centers in Addis Ketema, Sub-City of Addis Ababa, Ethiopia, in 2024. Methods: An institution-based retrospective cohort study was conducted among 432 adult patients receiving anti-retroviral therapy from in Addis Ketema Sub City at government health centers. The study population were selected from seven health centers using a simple random sampling technique from March 25,2024 to April `25,2024. Data were collected based on kobo toolbox from patients’ cards, ART registers, and electronic databases. Statical analysis using Stata Version 14 and SPSS Version 27. Cumulative survival probability was applied to estimated. The Kaplan-Meier survival curves by using the log rank test to compare the probability of survival among different groups. The Cox proportional hazard model was used to identify both bi-variable and multivariable. Variable at p-value <0.05 with 95% CI were significantly associated with loss to follow-up. Results: In this study, about 432 adults with human immunodeficiency virus were included. The incidence rate of loss to follow-up was 21.7 per 1000 person-moths (95%CI: 18.92; 24.98). Age groups (AHR: 5.93; 95%CI: 1.48; 23.65), level of adherence (AHR: 2.17; 95%CI: 1.51; 3.10), CD4 (AHR: 2.02; 95%CI: 1.41; 3.93), and viral load (AHR: 2.04; 95%CI: 1.10; 3.78) were significant determinants of loss to follow-up. Conclusion: In this study, the incidence of lost follow-up in adults receiving ART was high, which is a high loss-to-follow-up rate. Patients age groups, poor ART adherence, CD4, and high viral load were significantly associated with a loss of follow-up