Loss to follow-up and its predictors among children living with HIV on antiretroviral therapy, southern Oromia, Ethiopia: a 5-year retrospective cohort study

Background Loss to follow-up (LTFU) among paediatric patients living with HIV presents a significant challenge to the global scale-up of life-saving antiretroviral therapy (ART).Objectives This study aims to estimate LTFU incidence and its determinants among children with HIV on ART in Shashemene to...

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Main Authors: Assefa Washo Bankere, Sintayehu Gabisa Daba, Bonso Ami, Lalisa Kebebe Gedefa, Bikila Lencha
Format: Article
Language:English
Published: BMJ Publishing Group 2024-07-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/14/7/e078370.full
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author Assefa Washo Bankere
Sintayehu Gabisa Daba
Bonso Ami
Lalisa Kebebe Gedefa
Bikila Lencha
author_facet Assefa Washo Bankere
Sintayehu Gabisa Daba
Bonso Ami
Lalisa Kebebe Gedefa
Bikila Lencha
author_sort Assefa Washo Bankere
collection DOAJ
description Background Loss to follow-up (LTFU) among paediatric patients living with HIV presents a significant challenge to the global scale-up of life-saving antiretroviral therapy (ART).Objectives This study aims to estimate LTFU incidence and its determinants among children with HIV on ART in Shashemene town public health institutions, Oromia, Ethiopia.Design A retrospective cohort study from 1 January 2015 to 30 December 2020.Setting This study was conducted in Shashemene town, Oromia, Ethiopia.Participants Medical records of 269 children receiving ART at health facilities in Shashemene town were included.Methods Data from patients’ medical records were collected using a standardised checklist. EpiData V.3.1 was employed for data entry, while Statistical Package for the Social Sciences (SPSS) V.25 facilitated analysis. The Kaplan-Meier survival curve was used for estimation of survival time. To measure association, adjusted HRs (AHRs) with 95% CIs were calculated. Both bivariable and multivariable Cox proportional hazards regression models were employed to identify predictors of LTFU.Results Of the 269 children living with HIV included in the final analysis, 43 (16%) were lost to follow-up. The overall incidence rate of LTFU was 3.3 (95% CI 2.4 to 4.4) per 100 child-years of observation. Age less than 5 years (AHR 0.03, 95% CI 0.00 to 0.36), non-orphan status of the child (AHR 0.13, 95% CI 0.05 to 0.34), < 30 min distance to health facility (AHR 0.24, 95% CI 0.08 to 0.73), disclosed HIV status (AHR 0. 32, 95% CI 0.13 to 0.80), history of opportunistic infection (AHR 3.54, 95% CI 1.15 to 10.87) and low CD4 count (AHR 5.17, 95% CI 2.08 to 12.85) were significant predictors of LTFU.Conclusion The incidence rate of LTFU was lower compared with other studies in Ethiopia. This result indicated that age less than 5 years, non-orphans, low CD4, disclosed HIV status and distance from health facility were predictors of LTFU.
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spelling doaj-art-ba2db2936ac54c499c7645eedae99aca2025-08-20T02:13:14ZengBMJ Publishing GroupBMJ Open2044-60552024-07-0114710.1136/bmjopen-2023-078370Loss to follow-up and its predictors among children living with HIV on antiretroviral therapy, southern Oromia, Ethiopia: a 5-year retrospective cohort studyAssefa Washo Bankere0Sintayehu Gabisa Daba1Bonso Ami2Lalisa Kebebe Gedefa3Bikila Lencha4Department of Public Health, Hawassa College of Health Science, Hawassa, EthiopiaDepartment of Disease Prevention and Control, Oromia Regional Health Bureau, Bishoftu, Addis Ababa, EthiopiaDepartment of Public Health, Madda Walabu University, Robe, EthiopiaDepartment of Public Health, Madda Walabu University, Robe, EthiopiaDepartment of Public Health, Madda Walabu University, Robe, EthiopiaBackground Loss to follow-up (LTFU) among paediatric patients living with HIV presents a significant challenge to the global scale-up of life-saving antiretroviral therapy (ART).Objectives This study aims to estimate LTFU incidence and its determinants among children with HIV on ART in Shashemene town public health institutions, Oromia, Ethiopia.Design A retrospective cohort study from 1 January 2015 to 30 December 2020.Setting This study was conducted in Shashemene town, Oromia, Ethiopia.Participants Medical records of 269 children receiving ART at health facilities in Shashemene town were included.Methods Data from patients’ medical records were collected using a standardised checklist. EpiData V.3.1 was employed for data entry, while Statistical Package for the Social Sciences (SPSS) V.25 facilitated analysis. The Kaplan-Meier survival curve was used for estimation of survival time. To measure association, adjusted HRs (AHRs) with 95% CIs were calculated. Both bivariable and multivariable Cox proportional hazards regression models were employed to identify predictors of LTFU.Results Of the 269 children living with HIV included in the final analysis, 43 (16%) were lost to follow-up. The overall incidence rate of LTFU was 3.3 (95% CI 2.4 to 4.4) per 100 child-years of observation. Age less than 5 years (AHR 0.03, 95% CI 0.00 to 0.36), non-orphan status of the child (AHR 0.13, 95% CI 0.05 to 0.34), < 30 min distance to health facility (AHR 0.24, 95% CI 0.08 to 0.73), disclosed HIV status (AHR 0. 32, 95% CI 0.13 to 0.80), history of opportunistic infection (AHR 3.54, 95% CI 1.15 to 10.87) and low CD4 count (AHR 5.17, 95% CI 2.08 to 12.85) were significant predictors of LTFU.Conclusion The incidence rate of LTFU was lower compared with other studies in Ethiopia. This result indicated that age less than 5 years, non-orphans, low CD4, disclosed HIV status and distance from health facility were predictors of LTFU.https://bmjopen.bmj.com/content/14/7/e078370.full
spellingShingle Assefa Washo Bankere
Sintayehu Gabisa Daba
Bonso Ami
Lalisa Kebebe Gedefa
Bikila Lencha
Loss to follow-up and its predictors among children living with HIV on antiretroviral therapy, southern Oromia, Ethiopia: a 5-year retrospective cohort study
BMJ Open
title Loss to follow-up and its predictors among children living with HIV on antiretroviral therapy, southern Oromia, Ethiopia: a 5-year retrospective cohort study
title_full Loss to follow-up and its predictors among children living with HIV on antiretroviral therapy, southern Oromia, Ethiopia: a 5-year retrospective cohort study
title_fullStr Loss to follow-up and its predictors among children living with HIV on antiretroviral therapy, southern Oromia, Ethiopia: a 5-year retrospective cohort study
title_full_unstemmed Loss to follow-up and its predictors among children living with HIV on antiretroviral therapy, southern Oromia, Ethiopia: a 5-year retrospective cohort study
title_short Loss to follow-up and its predictors among children living with HIV on antiretroviral therapy, southern Oromia, Ethiopia: a 5-year retrospective cohort study
title_sort loss to follow up and its predictors among children living with hiv on antiretroviral therapy southern oromia ethiopia a 5 year retrospective cohort study
url https://bmjopen.bmj.com/content/14/7/e078370.full
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