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Predictors of loss to follow-up in art experienced patients in Nigeria: a 13 year review (2004–2017)
BACKGROUND: Expanded access to antiretroviral therapy (ART) leads to improved HIV/AIDS treatment outcomes in Nigeria, however, increasing rates of loss to follow-up among those on ART is threatening optimal standard achievement. Therefore, this retrospective cross-sectional study is aimed at identif...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6784330/ https://www.ncbi.nlm.nih.gov/pubmed/31594539 http://dx.doi.org/10.1186/s12981-019-0241-3 |
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author | Aliyu, Ahmad Adelekan, Babatunde Andrew, Nifarta Ekong, Eunice Dapiap, Stephen Murtala-Ibrahim, Fati Nta, Iboro Ndembi, Nicaise Mensah, Charles Dakum, Patrick |
author_facet | Aliyu, Ahmad Adelekan, Babatunde Andrew, Nifarta Ekong, Eunice Dapiap, Stephen Murtala-Ibrahim, Fati Nta, Iboro Ndembi, Nicaise Mensah, Charles Dakum, Patrick |
author_sort | Aliyu, Ahmad |
collection | PubMed |
description | BACKGROUND: Expanded access to antiretroviral therapy (ART) leads to improved HIV/AIDS treatment outcomes in Nigeria, however, increasing rates of loss to follow-up among those on ART is threatening optimal standard achievement. Therefore, this retrospective cross-sectional study is aimed at identifying correlates and predictors of loss to follow-up in patients commencing ART in a large HIV program in Nigeria. METHODS: Records of all patients from 432 US CDC Presidents Emergency Plan for AIDS Relief (PEPFAR) supported facilities across 10 States and FCT who started ART from 2004 to 2017 were used for this study. Bivariate and multivariate analysis of the demographic and clinical parameters of all patients was conducted using STATA version 14 to determine correlates and predictors of loss to follow-up. RESULTS: Within the review period, 245,257 patients were ever enrolled on anti-retroviral therapy. 150,191 (61.2%) remained on treatment, 10,960 (4.5%) were transferred out to other facilities, 6926 (2.8%) died, 2139 (0.9%) self-terminated treatment and 75,041 (30.6%) had a loss to follow-up event captured. Males (OR: 1.16), Non-pregnant female (OR: 4.55), Patients on ≥ 3-monthly ARV refills (OR: 1.32), Patients with un-suppressed viral loads on ART (OR: 4.52), patients on adult 2nd line regimen (OR: 1.23) or pediatric on 1st line regimen (OR: 1.70) were significantly more likely to be lost to follow-up. CONCLUSION: Despite increasing access to anti-retroviral therapy, loss to follow-up is still a challenge in the HIV program in Nigeria. Differentiated care approaches that will focus on males, non-pregnant females and paediatrics is encouraged. Reducing months of Anti-retroviral drug refill to less than 3 months is advocated for increased patient adherence. |
format | Online Article Text |
id | pubmed-6784330 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-67843302019-10-17 Predictors of loss to follow-up in art experienced patients in Nigeria: a 13 year review (2004–2017) Aliyu, Ahmad Adelekan, Babatunde Andrew, Nifarta Ekong, Eunice Dapiap, Stephen Murtala-Ibrahim, Fati Nta, Iboro Ndembi, Nicaise Mensah, Charles Dakum, Patrick AIDS Res Ther Research BACKGROUND: Expanded access to antiretroviral therapy (ART) leads to improved HIV/AIDS treatment outcomes in Nigeria, however, increasing rates of loss to follow-up among those on ART is threatening optimal standard achievement. Therefore, this retrospective cross-sectional study is aimed at identifying correlates and predictors of loss to follow-up in patients commencing ART in a large HIV program in Nigeria. METHODS: Records of all patients from 432 US CDC Presidents Emergency Plan for AIDS Relief (PEPFAR) supported facilities across 10 States and FCT who started ART from 2004 to 2017 were used for this study. Bivariate and multivariate analysis of the demographic and clinical parameters of all patients was conducted using STATA version 14 to determine correlates and predictors of loss to follow-up. RESULTS: Within the review period, 245,257 patients were ever enrolled on anti-retroviral therapy. 150,191 (61.2%) remained on treatment, 10,960 (4.5%) were transferred out to other facilities, 6926 (2.8%) died, 2139 (0.9%) self-terminated treatment and 75,041 (30.6%) had a loss to follow-up event captured. Males (OR: 1.16), Non-pregnant female (OR: 4.55), Patients on ≥ 3-monthly ARV refills (OR: 1.32), Patients with un-suppressed viral loads on ART (OR: 4.52), patients on adult 2nd line regimen (OR: 1.23) or pediatric on 1st line regimen (OR: 1.70) were significantly more likely to be lost to follow-up. CONCLUSION: Despite increasing access to anti-retroviral therapy, loss to follow-up is still a challenge in the HIV program in Nigeria. Differentiated care approaches that will focus on males, non-pregnant females and paediatrics is encouraged. Reducing months of Anti-retroviral drug refill to less than 3 months is advocated for increased patient adherence. BioMed Central 2019-10-08 /pmc/articles/PMC6784330/ /pubmed/31594539 http://dx.doi.org/10.1186/s12981-019-0241-3 Text en © The Author(s) 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Aliyu, Ahmad Adelekan, Babatunde Andrew, Nifarta Ekong, Eunice Dapiap, Stephen Murtala-Ibrahim, Fati Nta, Iboro Ndembi, Nicaise Mensah, Charles Dakum, Patrick Predictors of loss to follow-up in art experienced patients in Nigeria: a 13 year review (2004–2017) |
title | Predictors of loss to follow-up in art experienced patients in Nigeria: a 13 year review (2004–2017) |
title_full | Predictors of loss to follow-up in art experienced patients in Nigeria: a 13 year review (2004–2017) |
title_fullStr | Predictors of loss to follow-up in art experienced patients in Nigeria: a 13 year review (2004–2017) |
title_full_unstemmed | Predictors of loss to follow-up in art experienced patients in Nigeria: a 13 year review (2004–2017) |
title_short | Predictors of loss to follow-up in art experienced patients in Nigeria: a 13 year review (2004–2017) |
title_sort | predictors of loss to follow-up in art experienced patients in nigeria: a 13 year review (2004–2017) |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6784330/ https://www.ncbi.nlm.nih.gov/pubmed/31594539 http://dx.doi.org/10.1186/s12981-019-0241-3 |
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