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

Wubareg Seifu, Walid Ali, Beyene Meresa

Retention in care and adherence to the treatment is very important for the success of the program while access for treatment is being scaled up. Without more precise data about the rate of loss to follow up as well the characteristics of those who disengage from the treatment appropriate interventions to increase ART adherence cannot be designed and implemented. Therefore the aim of this study was to determine incidence and predictors of loss to follow up among adult ART clients attending in Karamara Hospital, Jigjiga town, Eastern Ethiopia, 2015. An institutional based retrospective cohort study were undertaken among 1439 adult people living with HIV/AIDS and attending ART clinic between September 1, 2007 and September 1, 2014 at Karamara Hospital was undertaken. Loss to follow up was defined as not taking an ART refill for a period of 90 days or longer from the last attendance for refill and not yet classified as 'dead' or 'transferred-out'. A Kaplan-Meier model was used to estimate rate of time to loss to follow up and Cox proportional hazards modeling was used to identify predictors of loss to follow up among ART clients. Of 1439 patients, 830(58.0%) were females in their sex. The mean age of the cohort was 33.5 years with a standard deviation of 9.33. Around 213 (14.8%) patients were defined as LTFU. The incidence rate of loss to follow up in the cohort was 26.6% (95% CI; 18.1-29.6) per 100 person months. Patients with male sex [HR: 2.1CI;(1.3-3.4)], patients whose next appointment weren't recorded [HR: 1.2, 95% CI; (1.12-1.36)] and patients who did not disclose their status to any one [HR: 2.8, 95% CI; (2.22-5.23)] were significantly associated with LTFU in the cox proportional model. Overall, these data suggested that LTFU in this study was high. The ART patients' next appointment should be documented very well and as well the clients should be advised to adhere with treatment program as per the schedule. Defaulter tracing mechanism should be operational and strengthen in the health facility. Effective control measures should be designed for at-risk population such as male patients.