Correlates of ART attrition among adults under antiretroviral therapy in Southern Ethiopia, retrospective cohort study.

IF 1.2 4区 医学 Q4 HEALTH POLICY & SERVICES Aids Care-Psychological and Socio-Medical Aspects of Aids/hiv Pub Date : 2024-07-01 Epub Date: 2023-12-29 DOI:10.1080/09540121.2023.2293758
Molalegn Mesele, Getachew Asmare, Gizachew Ambaw, Misganaw Asmamaw, Mohammed Abdu, Endeshaw Chekol, Denekew Tenaw, Sefineh Fenta, Tadesse Asmamaw, Melkamu Aderajew, Anteneh Mengist, Yenealem Solomon, Berihun Bantie, Wubet Alebachew, Natnael Atnafu
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Abstract

High attrition rates from ART are the primary contributors to morbidity, death, hospitalisation, rising transmission rates, treatment failure, rising burden of opportunistic infections (OIs), and the evolution of HIV-virus resistance (HIVDR). In Sub-Saharan Africa, more than two-thirds of ART patients will not receive continuous care. There is little information about the correlates that contribute to attrition from ART services among ART patients in Southern Ethiopia. Hence, this study aims to identify correlates of attrition from antiretroviral therapy services for adults under antiretroviral therapy at Otona Teaching and Referral Hospital, Wolaita Zone, Southern Ethiopia. From 1 January 2013 to 31 December 2017, a retrospective cohort analysis was performed. The pre-determined 328 medical records were chosen using a simple random sampling technique using computer-generated random numbers. Epi Info version 3.5.3 was used to enter and clean the data, which were then exported to STATA version 11 for analysis. The Cox proportional hazards model, both bivariate and multivariable, was used. Variables with p-values less than 0.25 in bivariate analysis were considered candidates for multivariable analysis, and variables with p-values less than 0.05 were deemed statistically important in multivariable analysis. The intensity of the correlation and statistical significance were determined using the CHR, AHR, and 95 per cent confidence intervals. The magnitude of attrition from ART service was 21.60% (95% CI: 17.10, 26.10). The distance between home and hospital is more than five kilometres (AHR:3.84;95% CI: 1.99,7.38), no registered phone number (AHR:2.47;95%CI:1.32,4.09), have not taken isoniazid prophylaxis (AHR:2.23;95%CI:1.30,4.09), alcohol consumption (AHR: 1.77; 95% CI:1.01, 3.12), and had no caregiver (AHR: 2.11; 95% CI:1.23, 3.60) were statistically significant in the Cox proportional hazard model. Distance between home and hospital, phone number registration on follow-up chart, having a history of alcohol consumption, isoniazid prophylaxis provision, and having family support were independent correlates of attrition from antiretroviral treatment services.

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埃塞俄比亚南部接受抗逆转录病毒疗法的成年人中抗逆转录病毒疗法流失的相关因素,回顾性队列研究。
抗逆转录病毒疗法的高流失率是导致发病、死亡、住院、传播率上升、治疗失败、机会性感染(OIs)负担加重以及艾滋病病毒耐药性(HIVDR)演变的主要原因。在撒哈拉以南非洲地区,三分之二以上的抗逆转录病毒疗法患者无法得到持续的治疗。关于导致埃塞俄比亚南部抗逆转录病毒疗法患者从抗逆转录病毒疗法服务中流失的相关因素的信息很少。因此,本研究旨在确定埃塞俄比亚南部沃莱塔区奥托纳教学和转诊医院接受抗逆转录病毒治疗的成人从抗逆转录病毒治疗服务中流失的相关因素。从2013年1月1日至2017年12月31日,我们进行了一项回顾性队列分析。使用计算机生成的随机数,通过简单随机抽样技术选取了预先确定的 328 份病历。使用 Epi Info 3.5.3 版输入和清理数据,然后导出到 STATA 11 版进行分析。分析中使用了 Cox 比例危险模型,包括双变量和多变量模型。在双变量分析中,P 值小于 0.25 的变量被认为是多变量分析的候选变量,而在多变量分析中,P 值小于 0.05 的变量被认为具有重要的统计学意义。相关性的强度和统计显著性通过 CHR、AHR 和 95% 的置信区间来确定。抗逆转录病毒疗法服务的自然减员率为 21.60%(95% CI:17.10,26.10)。家庭与医院之间的距离超过 5 公里(AHR:3.84;95%CI: 1.99,7.38),没有登记电话号码(AHR:2.47;95%CI:1.32,4.09),未服用异烟肼预防剂(AHR:2.23;95%CI:1.30,4.09)、饮酒(AHR:1.77;95%CI:1.01,3.12)和没有照顾者(AHR:2.11;95%CI:1.23,3.60)在 Cox 比例危险模型中均具有统计学意义。家庭与医院之间的距离、随访表上登记的电话号码、有饮酒史、提供异烟肼预防治疗以及有家庭支持是抗逆转录病毒治疗服务流失的独立相关因素。
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