scholarly journals Factors of Loss to Follow-up Antiretroviral Therapy in Islanded Area

2018 ◽  
Vol 7 (2) ◽  
pp. 98-103
Author(s):  
Thomas Laga Boro ◽  
Rafael Paun ◽  
Marthen R Pellokila

ABSTRACT Loss to follow-up of antiretroviral therapy is when PLWHA (People Living with HIV/AIDS) do not come for antiretroviral therapy for more than 3 months. This study aimed to determine the factors of loss to follow-up antiretroviral therapy for PLWHA at Prof. Dr. W. Z. Johannes Kupang Public Hospital where PLWHA with land, water and air transportation are served. This was a case control study with 66 samples of PLWHA. The samples underwent antiretroviral therapy in Prof. Dr.W.Z. Johannes Kupang Public Hospital from 2006 to 2016. Saturated sampling technique was done for cases group and simple random sampling was done for control group. Univariate and bivariate data analysis were done in this study. The result of bivariate analysis showed that there were association between intention (p = 0.004, OR = 4.667), self efficacy (p = 0.0001, OR = 7.875), action (p = 0.0001, OR = 45.000), transportation mode (p = 0.046, OR = 0.200), and transport costs (p = 0.0001, OR 19.333) and loss to follow-up antiretroviral therapy. It could be concluded that transportation and behavior were the major problems for the loss to follow up antiretroviral therapy in the islanded area.   Keywords: HIV/AIDS, antiretroviral therapy, loss to follow-up, islanded area   ABSTRAK Gagal follow-up antiretroviral therapy adalah  jika ODHA (Orang dengan HIV/AIDS) tidak menjalani terapi antireroviral lebih dari 3 bulan  terakhir. Penelitian ini bertujuan untuk mengetahui faktor-faktor gagal follow-up antiretroviral therapy pada ODHA di RSUD Prof. Dr. W. Z. Johannes Kupang yang melayani para ODHA dengan moda transportasi darat, air, dan udara. Desain penelitian ini adalah case control. Sampel sebanyak 66 ODHA yang menjalani antiretroviral therapy di RSUD Prof. Dr.W.Z. Johannes Kupang sejak tahun 2006 sampai 2016. Teknik pengambilan sampel yang digunakan adalah sampel jenuh untuk kelompok kasus dan simple random sampling untuk kelompok kontrol. Analisis data menggunakan prosentase untuk univariat dan bivariat. Hasil analisis bivariat menunjukkan ada pengaruh niat (p = 0,004, OR = 4,667), self efficacy (p = 0,0001, OR = 7,875), tindakan (p = 0,0001, OR = 45,000), moda transportasi (p = 0,046, OR = 0,200), dan biaya transportasi (p = 0,0001, OR 19,333) terhadap gagal  follow up terapi antiretroviral. Dapat disimpulkan bahwa masalah utama gagal follow up terapi antiretroviral di wilayah berkepulauan ini adalah transportasi dan perilaku.   Kata Kunci: HIV/AIDS,  terapi antiretroviral, gagal follow up, wilayah berkepulauan.

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Edwin Nuwagira ◽  
Boniface A. E. Lumori ◽  
Rose Muhindo ◽  
Michael Kanyesigye ◽  
Abdallah Amir ◽  
...  

Abstract Background Good adherence to antiretroviral therapy (ART) and retention in care are essential for the effectiveness of an HIV care program. With the current increase in numbers of people living with HIV taking second-line ART in sub-Saharan Africa, there is a need to establish their treatment outcomes and the rate of loss to follow up. In this study, we determined the incidence and predictors of loss to follow up among patients taking second-line ART at an experienced HIV treatment center in southwestern Uganda. Methods This was a retrospective review of an electronic database at Mbarara Regional Referral Hospital HIV clinic in southwestern Uganda. Second-line ART included at least two of the nucleoside reverse transcriptase inhibitors and a boosted protease inhibitor. Loss to follow-up was defined as failure to return to the health facility for care or treatment refill for 180 days or more from the previous visit. After excluding children less than 15 years, we pooled data that included socio-demographic, clinical, and laboratory data for patients who started second-line ART between 2002 and 2017. Multiple imputation was done for variables with missing data. Variables that had a p < 0.05 in unadjusted bivariate analyses were included in a multivariate binomial regression model using a stepwise backward selection procedure to describe the factors that independently predicted loss to follow-up. Results Between 2002 and 2017, 1121 patients had been initiated on second-line ART. We included data from 924 participants and of these, 518 (56.1%) were female, the mean age (SD) was 38.4 (± 10.5) years, and 433 (52.4%) had a CD4 count less than 100 cells/µl at the start of second-line ART. The incidence of loss to follow-up was 26.7 per 100 person-years. Male gender (Adjusted risk ratio (ARR) = 1.8, 95% CI 1.5–2.0) p < 0.001 and anemia ARR 1.4, 95% CI 1.1–1.6) p < 0.001 were strongly associated with loss to follow up. Conclusions There is a high incidence of loss to follow up among patients taking protease-inhibitor based second-line ART at a tertiary HIV center in southwestern Uganda. There is a need to routinely measure hemoglobin during clinic reviews, and establish mechanisms to retain males initiated on second-line ART in care. The association of anemia and loss to follow up needs to be investigated.


2021 ◽  
Vol 20 (1) ◽  
pp. 93-99
Author(s):  
Farouq Muhammad Dayyab ◽  
Fahad Mukhtar ◽  
Garba Iliyasu ◽  
Abdulrazaq Garba Habib

2019 ◽  
Vol 10 (2) ◽  
pp. 98
Author(s):  
Mellia Fransiska ◽  
M Mursyid

Hasil pemetaan oleh KPAKota Bukittinggi terdapat 67 titik hospot homoseksual dengan populasi kunci sebanyak 456 orang. Tujuan Penelitian ini adalah untuk mengetahui analisis mendalam keterkaitan jumlah pasangan seksual dan pemakaian kondom pada komunitas homoseksual dengan kejadian HIV AIDS. Penelitian ini merupakan penelitian observasional analitik dengan desain case control. Populasi kasus adalah semua homoseksual di Kota Bukittinggi tahun 2017 sebanyak 465 orang dan jumlah sampel kasus 19 orang (homoseksual dengan HIV +) dan sampel kontrol 19 orang (homoseksual HIV -). Teknik pengambilan sampel kasus dengan simple random sampling dan kontrol dengan purposive sampling (berdasarkan kelompok kasus). Data kuantitatif dikumpulkan dengan menggunakan kuisioner. Data kuantitatif dianalisis dengan uji chi-square (CI 95%) Hasil penelitian menunjukkan bahwa konsistensi pemakaian kodom (OR = 16,200; CI 95%) merupakan faktor risiko penularan HIV AIDS pada komunitas homoseksual, dan secara statistik terdapat pemakaian kondom (p= 0,003) dengan penularan HIV AIDS pada komunitas homoseksual. Dapat disimpulkan bahwa responden yang tidak konsisten menggunakan kondom, 16,200 kali berisiko untuk tertular HIV dibandingkan dengan responden yang konsisten menggunakan. Diharapkan kepada pihak terkait dalam pencegahan dan penanggulangan HIV AIDS untuk dapat membuat sebuah program pecegahan dan penanggulangan HIV AIDS pada komunitas homoseksual mengenai hubugan seks yang aman pada komunitas homoseksual. Diperlukan program spesifik tentang pencegahan penularan HIV AIDS khususnya pada komunitas homoseksual yang dapat dimotoring dan dievaluasi secara berkala.


Author(s):  
Bernhard Kerschberger ◽  
Andrew Boulle ◽  
Rudo Kuwengwa ◽  
Iza Ciglenecki ◽  
Michael Schomaker

Abstract Rapid initiation of antiretroviral therapy (ART) is recommended for people living with HIV, with the option to start treatment on the day of diagnosis (same-day-ART). However, the effect of same-day-ART remains unknown in realistic public sector settings. We established a cohort of ≥16-year-old patients who initiated first-line ART under Treat-All in Nhlangano (Eswatini) between 2014-2016, either on the day of HIV care enrolment (same-day-ART) or 1–14 days thereafter (early-ART). Directed acyclic graphs, flexible parametric survival analysis and targeted maximum likelihood estimation (TMLE) were used to estimate the effect of same-day-ART initiation on the composite unfavourable treatment outcome (loss to follow-up;death;viral failure). Of 1328 patients, 839 (63.2%) initiated same-day ART. The adjusted hazard ratio of the unfavourable outcome was increased by 1.48 (95% CI:1.16–1.89) for same-day-ART compared with early-ART. TMLE suggested that after 1 year, 28.9% of patients would experience the unfavourable outcome under same-day-ART compared with 21.2% under early-ART (difference: 7.7%; 1.3–14.1%). This estimate was driven by loss to follow-up and varied over time, with a higher hazard during the first year after HIV care enrolment and a similar hazard thereafter. We found an increased risk with same-day-ART. A limitation was possible silent transfers that were not captured.


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