The attrition rate of patients in the antiretroviral therapy program in two outpatient treatment centers in Bangui.

Abstract

To determine the rate of attrition of patients in the antiretroviral treatment program in Bangui and factors associated with this loss to follow-up. This was a retrospective descriptive, analytical cohort study from January 1, 2014 to March 31, 2017 in two large outpatient treatment centers in Bangui. Data were entered in and analyzed with Epi info version 3.5.4 software. Survival probability was calculated by a Kaplan Meier curve. The Cox model and logistic regression were used to determine the association between attrition and risk factors. A total of 292 patients were registered. Attrition rates at 6, 12, and 24 months were 14%, 20% and 31%, respectively. Factors associated with attrition were patients' age (young), living alone (compared to living with a partner), distance between place of residence and treatment center, presence of opportunistic infections, low hemoglobin levels, and lack of therapeutic education. This study identified the main risk factors for patients leaving the care system. Innovative strategies including differentiated approaches must be implemented to improve quality of screening, early start of treatment, and geographical access to care. Particular emphasis should be placed on therapeutic education to train and educate patients about their illness and how to manage it.