Attrition during pre-ART and ART time periods among adolescents enrolled in Integrated HIV Care Programme in Myanmar, 2005–2017

Htun, Thurain; Kyaw, Khine Wut Yee; Aung, Thet Ko; Moe, July; Mon, Aye Aye; Tun, C L; Mon, O; Satyanarayana, Srinath; Oo, Htun Nyunt

doi:10.1017/s0950268819000906

Cited by 4 publications

(2 citation statements)

References 13 publications

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“…Our study observed a high rate of loss to follow up among adolescents compared to WHO 90-90-90 targets., Nevertheless, this rate of LTFU among adolescents was observed to be low compared to the study conducted in Myanmar (69%) [ 19 ]. However compared to our results, a low proportion of loss to follow up on ART was reported in a study conducted in Ethiopia (13.6%) [ 20 ].…”

Section: Discussionmentioning

confidence: 71%

Predictors of loss to follow up from antiretroviral therapy among adolescents with HIV/AIDS in Tanzania

Tesha

Kishimba²,

Njau³

et al. 2022

PLoS ONE

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Access to Antiretroviral Therapy (ART) is threatened by the increased rate of loss to follow-up (LTFU) among adolescents on ART care. We investigated the rate of LTFU from HIV care and associated predictors among adolescents living with HIV/AIDS in Tanzania. A retrospective cohort analysis of adolescents on ART from January 2014 to December 2016 was performed. Kaplan-Meier method was used to determine failure probabilities and the Cox proportion hazard regression model was used to determine predictors of loss to follow up. A total of 25,484 adolescents were on ART between 2014 and 2016, of whom 78.4% were female and 42% of adolescents were lost to follow-up. Predictors associated with LTFU included; adolescents aged 15–19 years (adjusted hazard ratio (aHR): 1.57; 95% Confidence Interval (CI); 1.47–1.69), having HIV/TB co-infection (aHR: 1.58; 95% CI, 1.32–1.89), attending care at dispensaries (aHR: 1.12; 95% CI, 1.07–1.18) or health center (aHR: 1.10; 95% CI, 1.04–1.15), and being malnourished (aHR: 2.27; 95% CI,1.56–3.23). Moreover, residing in the Lake Zone and having advanced HIV disease were associated with LTFU. These findings highlight the high rate of LTFU and the need for intervention targeting older adolescents with advanced diseases and strengthening primary public facilities to achieve the 2030 goal of ending HIV as a public health threat.

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Section: Discussionmentioning

confidence: 71%

Predictors of loss to follow up from antiretroviral therapy among adolescents with HIV/AIDS in Tanzania

Tesha

Kishimba²,

Njau³

et al. 2022

PLoS ONE

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“…Retention was defined as children who were alive and on follow-up in the clinic at the end of the study period and children who were transferred out at any time during the study period. 11 …”

Section: Methodsmentioning

confidence: 99%

Attrition and associated factors among children living with HIV at a tertiary hospital in Eritrea: a retrospective cohort analysis

Mengistu

Ghebremeskel

Rezene

et al. 2022

bmjpo

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BackgroundReducing attrition in paediatric HIV-positive patients using combined antiretroviral therapy (cART) programmes in sub-Saharan Africa is a challenge. This study explored the rates and predictors of attrition in children started on cART in Asmara, Eritrea.MethodsThis was a retrospective cohort study using data from all paediatric patients on cART between 2005 and 2020, conducted at the Orotta National Referral and Teaching Hospital. Kaplan-Meier estimates of the likelihood of attrition and multivariate Cox proportional hazards models were used to assess the factors associated with attrition. All p values were two sided and p<0.05 was considered statistically significant.ResultsThe study enrolled 710 participants with 374 boys (52.7%) and 336 girls (47.3%). After 5364 person-years’ (PY) follow-up, attrition occurred in 172 (24.2%) patients: 65 (9.2%) died and 107 (15.1%) were lost to follow-up (LTFU). The crude incidence rate of attrition was 3.2 events/100 PY, mortality rate was 2.7/100 PY and LTFU was 1.2/100 PY. The independent predictors of attrition included male sex (adjusted HR (AHR)=1.6, 95% CI: 1 to 2.4), residence outside Zoba Maekel (AHR=1.5, 95% CI: 1 to 2.3), later enrolment years (2010–2015: AHR=3.2, 95% CI: 1.9 to 5.3; >2015: AHR=6.1, 95% CI: 3 to 12.2), WHO body mass index-for-age z-score <−2 (AHR=1.4, 95% CI: 0.9 to 2.1), advanced HIV disease (WHO III or IV) at enrolment (AHR=2.2, 95% CI: 1.2 to 3.9), and initiation of zidovudine+lamivudine or other cART backbones (unadjusted HR (UHR)=2, 95% CI: 1.2 to 3.2). In contrast, a reduced likelihood of attrition was observed in children with a record of cART changes (UHR=0.2, 95% CI: 0.15 to 0.4).ConclusionA low incidence of attrition was observed in this study. However, the high mortality rate in the first 24 months of treatment and late presentation are concerning. Therefore, data-driven interventions for improving programme quality and outcomes should be prioritised.

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Correlates of ART attrition among adults under antiretroviral therapy in Southern Ethiopia, retrospective cohort study

Mesele,

Asmare,

Ambaw

et al. 2023

AIDS Care

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Attrition during pre-ART and ART time periods among adolescents enrolled in Integrated HIV Care Programme in Myanmar, 2005–2017

Cited by 4 publications

References 13 publications

Predictors of loss to follow up from antiretroviral therapy among adolescents with HIV/AIDS in Tanzania

Predictors of loss to follow up from antiretroviral therapy among adolescents with HIV/AIDS in Tanzania

Attrition and associated factors among children living with HIV at a tertiary hospital in Eritrea: a retrospective cohort analysis

Correlates of ART attrition among adults under antiretroviral therapy in Southern Ethiopia, retrospective cohort study

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