Predictors of lost to follow up to antiretroviral therapy in primary public hospital of Wukro, Tigray, Ethiopia: A case control study

In spite of the well proven benefits of antiretroviral therapy (ART) in prolonging life expectancy, being lost to ART follow-up is a problem to the success of antiretroviral therapy programs in resource limited countries including Ethiopia. Thus the aim of the study was to assess the magnitude and predictors of loss to follow-up among adult ART clients. A case-control study design was employed using patients’ chart review. For each case three controls were selected based on the closest day of enrollment. Both bivariate and multivariate logistic regression was performed to test association. A total of 727 adult patients were started on antiretroviral therapy during the study period. Among these, 80 (11%) were found to be lost from follow up for a period of ≥ 3 months and 240 controls were randomly selected for 80 cases in a ratio of 1:3. Presence of bereavement concern, not being provided with isoniazide (INH) prophylaxis, the presence of side effects and earlier periods after ART initiating were found to be associated with increased odds for being lost to follow up. The proportion of lost to follow up in this study was lower than those figures reported for resource poor countries. Thus, more targeted health education, counseling and follow-up is needed for patients with identified risk factors.