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Paper Details: Attrition Rate And Predictors Among Adult Patients Receiving Antiretroviral Therapy In Adama Hospital Medical College, Central Ethiopia: A Retrospective Cohort Study Design, 2006 - 2017

Volume 3 - Issue 8, August 2019 Edition
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Author(s)
Tamrat Endebu Gebre, Alemayehu Bekele
Keywords
Antiretroviral-therapy, Attrition, Ethiopia, predictors
Abstract
Introduction: Efforts are underway in Ethiopia to achieve the 90:90:90 treatment goals set by the UNAIDS. Patient attrition from the treatment is known that a major challenge to ensure long-term retention. Therefore, this study aimed to assess attrition and it’s predictors among adult patients receiving ART in Adama Hospital Medical College, Ethiopia, from 2006 to 2017. Methods: A retrospective cohort study design was used. Adult patients started ART from January 2006 to December 2017were followed up for 12 years. The statistical analysis was done by using SPSS version 21 statistical software. Descriptive analysis was used present frequencies and mean/median of variables. The Kaplan–Meier survival probability was used to estimate the probability of attrition at different time points. The multivariate Cox-proportional hazard model was used to identify predictors of attrition. Results: A total of 7990 patients were followed and observed for 52,934 person-years. At the end of the follow up period, 1016 attrition due to LTFU or death occurred with an annual incidence density [95% CIs] of 19.2% (18.0–20.4). Younger age, male gender, rural resident, not fully recorded patient address in the follow up form, lower CD4 count at baseline and WHO clinical stages III/IV at ART initiation were predictors of time to attrition. Conclusion: Considerable incidence of attrition from antiretroviral therapy was observed. Therefore, the hospital management and other concerned staffs should aggressively conduct the lost to follow up tracking measures. Beside that targeted interventions to the above predictors can reduce attrition from care and treatment.
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