Nearly one in every six HIV-infected children lost from ART follow-up at Debre Markos Referral Hospital, Northwest Ethiopia: A 14-year retrospective follow-up study.

Hibstie, YT; Kibret, GD; Talie, A; Temesgen, B; Melkamu, MW; Alebel, A

Nearly one in every six HIV-infected children lost from ART follow-up at Debre Markos Referral Hospital, Northwest Ethiopia: A 14-year retrospective follow-up study.

Hibstie, YT Kibret, GD Talie, A Temesgen, B Melkamu, MW Alebel, A

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Publisher:: Public Library of Science (PLoS)
Publication Type:: Journal Article
Citation:: PLoS One, 2020, 15, (9), pp. e0239013-e0239013
Issue Date:: 2020-01

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Field	Value	Language
dc.contributor.author	Hibstie, YT
dc.contributor.author	Kibret, GD
dc.contributor.author	Talie, A
dc.contributor.author	Temesgen, B
dc.contributor.author	Melkamu, MW
dc.contributor.author	Alebel, A
dc.date.accessioned	2021-05-23T23:47:45Z
dc.date.available	2020-08-27
dc.date.available	2021-05-23T23:47:45Z
dc.date.issued	2020-01
dc.identifier.citation	PLoS One, 2020, 15, (9), pp. e0239013-e0239013
dc.identifier.issn	1932-6203
dc.identifier.issn	1932-6203
dc.identifier.uri	http://hdl.handle.net/10453/149110
dc.description.abstract	<h4>Background</h4>Although antiretroviral therapy (ART) significantly improves the survival status and quality of life among human immunodeficiency virus (HIV)-infected children, loss to follow-up (LTFU) from HIV-care profoundly affecting the treatment outcomes of this vulnerable population. For better interventions, up-to-date information concerning LTFU among HIV-infected children on ART is vital. However, only a few studies have been conducted in Ethiopia to address this concern. Thus, this study aims to identify the predictors of LTFU among HIV-infected children receiving ART at Debre Markos Referral Hospital.<h4>Methods</h4>An institution-based retrospective follow-up study was done among 408 HIV-infected children receiving ART at Debre Markos Referral Hospital between 2005 and March 15, 2019. Data were abstracted from the medical records of HIV-infected children using a standardized data abstracted checklist. We used Epi-Data Version 3.1 for data entry and Stata Version 14 for statistical analysis. The Kaplan-Meier survival curve was used to estimate the survival time. A generalized log-rank test was used to compare the survival curves of different categorical variables. Finally, both bi-variable and multivariable Cox proportional hazard regression models were used to identify the predictors of LTFU.<h4>Results</h4>Of 408 HIV-infected children included in the final analysis, 70 (17.1%) children were LTFU at the end of the study. The overall incidence rate of LTFU among HIV-infected children was found to be 4.5 (95%CI: 3.5-5.7) per 100-child years of observation. HIV-infected children living in rural areas (AHR: 3.2, 95%CI: 2.0-5.3), having fair or poor ART drug adherence (AHR: 2.3, 95%CI: 1.4-3.7), children started ART through test and treat approach (AHR: 2.7, 95%CI: 1.4-5.5), and children started protease inhibiter (PI)-based ART regimens (AHR: 2.2, 95%CI: 1.1-4.4) were at higher risk of LTFU.<h4>Conclusion</h4>This study found that one in every six HIV-infected children lost form ART follow-up. HIV-infected children living in rural areas, having fair or poor ART drug adherence, started ART based on test and treat approach, and taking PI-based ART regimens were at higher risk of LTFU.
dc.format	Electronic-eCollection
dc.language	eng
dc.publisher	Public Library of Science (PLoS)
dc.relation.ispartof	PLoS One
dc.relation.isbasedon	10.1371/journal.pone.0239013
dc.rights	info:eu-repo/semantics/openAccess
dc.subject.classification	General Science & Technology
dc.subject.mesh	Adolescent
dc.subject.mesh	Anti-Retroviral Agents
dc.subject.mesh	Child
dc.subject.mesh	Child, Preschool
dc.subject.mesh	Ethiopia
dc.subject.mesh	Female
dc.subject.mesh	Follow-Up Studies
dc.subject.mesh	HIV Infections
dc.subject.mesh	Humans
dc.subject.mesh	Incidence
dc.subject.mesh	Kaplan-Meier Estimate
dc.subject.mesh	Lost to Follow-Up
dc.subject.mesh	Male
dc.subject.mesh	Proportional Hazards Models
dc.subject.mesh	Referral and Consultation
dc.subject.mesh	Retrospective Studies
dc.subject.mesh	Risk Factors
dc.subject.mesh	Humans
dc.subject.mesh	HIV Infections
dc.subject.mesh	Anti-Retroviral Agents
dc.subject.mesh	Incidence
dc.subject.mesh	Proportional Hazards Models
dc.subject.mesh	Risk Factors
dc.subject.mesh	Retrospective Studies
dc.subject.mesh	Follow-Up Studies
dc.subject.mesh	Adolescent
dc.subject.mesh	Child
dc.subject.mesh	Child, Preschool
dc.subject.mesh	Referral and Consultation
dc.subject.mesh	Ethiopia
dc.subject.mesh	Female
dc.subject.mesh	Male
dc.subject.mesh	Kaplan-Meier Estimate
dc.subject.mesh	Lost to Follow-Up
dc.subject.mesh	Adolescent
dc.subject.mesh	Anti-Retroviral Agents
dc.subject.mesh	Child
dc.subject.mesh	Child, Preschool
dc.subject.mesh	Ethiopia
dc.subject.mesh	Female
dc.subject.mesh	Follow-Up Studies
dc.subject.mesh	HIV Infections
dc.subject.mesh	Humans
dc.subject.mesh	Incidence
dc.subject.mesh	Kaplan-Meier Estimate
dc.subject.mesh	Lost to Follow-Up
dc.subject.mesh	Male
dc.subject.mesh	Proportional Hazards Models
dc.subject.mesh	Referral and Consultation
dc.subject.mesh	Retrospective Studies
dc.subject.mesh	Risk Factors
dc.title	Nearly one in every six HIV-infected children lost from ART follow-up at Debre Markos Referral Hospital, Northwest Ethiopia: A 14-year retrospective follow-up study.
dc.type	Journal Article
utslib.citation.volume	15
utslib.location.activity	United States
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/Public Health
utslib.copyright.status	open_access	*
pubs.consider-herdc	true
dc.date.updated	2021-05-23T23:47:41Z
pubs.issue	9
pubs.publication-status	Published
pubs.volume	15
utslib.citation.issue	9

Abstract:

Background

Although antiretroviral therapy (ART) significantly improves the survival status and quality of life among human immunodeficiency virus (HIV)-infected children, loss to follow-up (LTFU) from HIV-care profoundly affecting the treatment outcomes of this vulnerable population. For better interventions, up-to-date information concerning LTFU among HIV-infected children on ART is vital. However, only a few studies have been conducted in Ethiopia to address this concern. Thus, this study aims to identify the predictors of LTFU among HIV-infected children receiving ART at Debre Markos Referral Hospital.

Methods

An institution-based retrospective follow-up study was done among 408 HIV-infected children receiving ART at Debre Markos Referral Hospital between 2005 and March 15, 2019. Data were abstracted from the medical records of HIV-infected children using a standardized data abstracted checklist. We used Epi-Data Version 3.1 for data entry and Stata Version 14 for statistical analysis. The Kaplan-Meier survival curve was used to estimate the survival time. A generalized log-rank test was used to compare the survival curves of different categorical variables. Finally, both bi-variable and multivariable Cox proportional hazard regression models were used to identify the predictors of LTFU.

Results

Of 408 HIV-infected children included in the final analysis, 70 (17.1%) children were LTFU at the end of the study. The overall incidence rate of LTFU among HIV-infected children was found to be 4.5 (95%CI: 3.5-5.7) per 100-child years of observation. HIV-infected children living in rural areas (AHR: 3.2, 95%CI: 2.0-5.3), having fair or poor ART drug adherence (AHR: 2.3, 95%CI: 1.4-3.7), children started ART through test and treat approach (AHR: 2.7, 95%CI: 1.4-5.5), and children started protease inhibiter (PI)-based ART regimens (AHR: 2.2, 95%CI: 1.1-4.4) were at higher risk of LTFU.

Conclusion

This study found that one in every six HIV-infected children lost form ART follow-up. HIV-infected children living in rural areas, having fair or poor ART drug adherence, started ART based on test and treat approach, and taking PI-based ART regimens were at higher risk of LTFU.

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http://hdl.handle.net/10453/149110