Risk factors for loss to follow-up in human immunodeficiency virus care in the Greater Accra Regional Hospital in Ghana: a retrospective cohort study
Date
2019-06-11
Journal Title
Journal ISSN
Volume Title
Publisher
International Health
Abstract
Background: Loss of human immunodeficiency virus (HIV)-positive patients to follow-up increases HIV-related
morbidity and mortality. This study identified the factors associated with loss to follow-up (LTFU) in an urban
health facility in Ghana.
Methods: A 12-y retrospective study was conducted using routinely collected data from the National Acquired
Immune Deficiency Syndrome (AIDS) Control Programme (NACP) on persons living with HIV/AIDS (PLWHA)
who initiated antiretroviral therapy (ART) from 2006 to 2017 at the Greater Accra Regional Hospital.
Convenience sampling was used to select the study area. All gathered data were exported to Stata 14 statistical
software for analysis.
Results: A total of 4330 PLWHA initiated ART between January 2006 and December 2017. Of these, 1166
(26.9%) were lost to follow-up over the 12-y period. The factors associated with LTFU included being a Muslim
(adjusted hazard ratio [aHR] 1.31 [95% confidence interval {CI} 1.05 to 1.65]), having CD4 <250 cells/ml (aHR
1.45 [95% CI 1.21 to 1.76]) and completing adherence counselling (aHR 1.58 [95% CI 1.31 to 1.92]). Having
other sources of health care funding and disclosure of one’s disease status were found to be protective (aHR
0.74 [95% CI 0.58 to 0.94] and 0.80 [95% CI 0.65 to 0.98], respectively).
Conclusions: Some of the determinants of LTFU in the hospital are comparable to those found in other parts
of Africa and could be addressed using existing interventions.
Description
Research Article
Keywords
Africa, antiretroviral therapy, HIV/AIDS, Ghana, loss to follow-up