Abstract:
Background: As much success has been made internationally and nationally on ART
rollout and reduction of morbidity and mortality, adherence and long term retention of patients in
treatment programs (preventing loss to follow up) has remained a challenge.
Objectives This study aimed to assess the magnitude as well as factors associated with loss to
follow up in the ART program of St Peters Hospital, Addis Ababa. More over it also described
the perspectives of patients on why they discontinue ART.
Methods: a cohort of patients who started ART in St Peters Hospital from Megabit 1998 EC
(March 2006) to Hidar 2000 EC (November 2007) were retrospectively followed. Data was
collected using a pre tested abstraction form from ART intake and follow up national forms on
demographic variables, living condition, behaviour, clinical variables and Outcome. The
qualitative part used in depth interview of patients and key informants to describe their
perspectives.
Results: 1095 patients contributed to 1234.36 person years of follow up during which 370
LTFUs occurred. Incidence of LTFU was 300 per 1000 person years (CI: 269, 330). Median time
of loss to follow up is 59 days, (IQR: 0.00, 193). Independent predictors of loss to follow up are
age (p=.014, HR=.98), functional status (p=.044, HR=.54), baseline CD4 count (p=.037,
HR=.998) and Understanding of HIV disease (p=.018, HR=3.325). Reasons for discontinuation
of ART include going to holy water, poverty and lack of food, going to the regions for
“personal” reasons, and substance use especially among the youth and young adults.
