Master of Public Health in Epidemiology

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Author: search.filters.author.RUTH TESFAYESubject: search.filters.subject.Ethiopia.

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    INCIDENCE AND PREDICTORS OF LOSS TO FOLLOW UP AMONG ADULTS ON ANTIRETROVIRAL THERAPY AT PUBLIC HEALTH FACILITIES IN HAWASSA, SIDAMA REGION, ETHIOPIA, 2024
    (hawassa universty, 2024-06) RUTH TESFAYE
    Background: Despite significant progress in treatment and prevention, the global HIV/AIDS pandemic remains a serious threat to public health. HIV-related mortality and morbidity have greatly decreased as a result of ART, transforming HIV into a chronic, manageable condition. However, loss to follow-up hinders efforts to manage the HIV pandemic and is a substantial challenge. Objectives: The objective of this study was to determine the incidence and predictors of loss to follow up among adults on ART in Hawassa, Sidama, Ethiopia 2024. Methods: An institution-based retrospective follow up study was conducted. The study utilized data from four selected ART clinics, collected retrospectively on 459 study participants from September 11, 2018 to September 11, 2023. A simple random sampling technique was employed. Data were extracted from patients' charts and registration books using KOBO Toolbox and exported to SPSS for analysis. The incidence of LTFU was calculated using cumulative incidence and incidence density rates. Kaplan-Meier survival curves were employed, providing insights into LTFU patterns. Predictors of LTFU were determined using multivariable Cox proportional-hazard regression. Result: A total of 459 participants were included in the study, contributing 1386 person years of follow-up. The cumulative incidence of loss to follow-up (LTFU) was 16.6%, with an incidence density rate of 5.48 per 100 person-years [95% CI: 4.37- 6.86]. Significant predictors of LTFU included younger age groups (AHR 2.77, 95% CI: 1.06 - 7.19), lack of education (AHR 4.08, 95% CI: 1.34 - 12.43), WHO stage III (AHR 3.06, 95% CI: 1.04 - 8.99), WHO stage IV (AHR 4.64, 95% CI: 1.82 - 11.85), and being bedridden (AHR 3.63, 95% CI: 1.42 - 9.32). These factors were identified as significant predictors of LTFU in this cohort of ART patients in Hawassa, Ethiopia. Conclusions: This study found that the incidence of LTFU was moderate relative to certain global and local findings. Age, education, WHO clinical stage, functional status and CPT treatment are found significant predictors of LTFU. These findings highlight the need for targeted interventions to address the specific challenges faced by the identified vulnerable groups.