%0 Journal Article
%T High Loss to Followup and Early Mortality Create Substantial Reduction in Patient Retention at Antiretroviral Treatment Program in North-West Ethiopia
%A Mamo Wubshet
%A Yemane Berhane
%A Alemayehu Worku
%A Yigzaw Kebede
%A Ermias Diro
%J ISRN AIDS
%D 2012
%R 10.5402/2012/721720
%X Background. There has been a rapid scale up of antiretroviral therapy (ART) in Ethiopia since 2005. We aimed to evaluate mortality, loss to followup, and retention in care at HIV Clinic, University of Gondar Hospital, north-west Ethiopia. Method. A retrospective patient chart record analysis was performed on adult AIDS patients enrolled in the treatment program starting from 1 March 2005. We performed survival analysis to determine, mortality, loss to followup and retention in care. Results. A total of 3012 AIDS patients were enrolled in the ART Program between March 2005 and August 2010. At the end of the 66 months of the program initiation, 61.4% of the patients were retained on treatment, 10.4% died, and 31.4% were lost to followup. Fifty-six percent of the deaths and 46% of those lost to followup occurred in the first year of treatment. Male gender (adjusted hazard ratio (AHR) was 3.26; 95% CI: 2.19每4.88); CD4 count ≒200 cells/米L (AHR 5.02; 95% CI: 2.03每12.39), tuberculosis (AHR 2.91; 95% CI: 2.11每4.02); bed-ridden functional status (AHR 12.88; 95% CI: 8.19每20.26) were predictors of mortality, whereas only CD4 count <200 cells/米L (HR = 1.33; 95% CI: (0.95, 1.88) and ambulatory functional status (HR = 1.65; 95% CI: (1.22, 2.23) were significantly associated with LTF. Conclusion. Loss to followup and mortality in the first year following enrollment remain a challenge for retention of patients in care. Strengthening patient monitoring can improve patient retention AIDS care. 1. Background Ethiopia is one of the few countries with the highest number of people living with HIV/AIDS globally. According to Ethiopian Demographic and Health Survey (EDHS) 2011, Federal Ministry of Health (FMOH) and HIV/AIDS Prevention and Control Office (HAPCO) estimated that adult HIV prevalence was 1.5% of which 73,000 people require ART 2010 [1]. A fee-based ART program in 2003, and a free antiretroviral therapy (ART) program in early 2005 was started [2]. Subsequently, a number of initiatives have been undertaken to expand the availability of ART in Ethiopia. Task shifting and decentralization of the service to increasing numbers of both health centers and hospitals was done since August 2006 [3]. The provision of antiretroviral treatment has decreased morbidity and mortality in people living with HIV [3每7]. There have been several enabling factors for rapid scale-up of ART in resource-limited settings. Despite recent progress in improving access to ART, limited uptake, poor retention, and difficulties in accessing care remain a serious concern for ART programs [3, 4,
%U http://www.hindawi.com/journals/isrn.aids/2012/721720/