Abstract
Abstract Background: HIV remains one of the major public health issues in Cameroon. Progress has been made in attaining the 90-90-90 according to the UNAIDS target, the Loss to follow-up (LTFU) remains a significant challenge to attain the second and third 90. There is a gap of information concerning assessing predictors and determinants of LTFU in the Cameroonian setting taking into consideration psychosocial, economic, cultural, financial, and treatment-related factors. This study seeks to assess and evaluate the determinants and predictors of LTFU among patients enrolled for treatment in the Centre Hospitalier Essos (CHE), Cameroon. Methods: We carried out a retrospective case-control study among 200 patients from which, 100 cases of patients LTFU and 100 controls of regular patients from the treatment centre. Simple random sampling was used to select 100 participants from the case list and matched with 100 participants from the control list. We compared several demographic, social, disease-related, and treatment-related characteristics of the two groups to determine which properties are significantly associated with LTFU. Data analysis was done using the SPSS software. Bivariate and multivariate analysis was done with p value < 0.05, odds ratio 95% CI. Results: Out of 200 participants, the mean age was 38 ± 9years. A total of 74 (37%) participants' HIV status was known by a family member. About 50% (54) of those who were married had an HIV-positive partner and of these, 86% (46) were on treatment. On multivariate analysis, distance to health facility; occurrence of opportunistic infections; patient receiving treatment for other conditions; duration of psychological follow-up and number of adherence counselling sessions were found to be independently associated with loss to follow-up. Conclusion: With LTFU, there is a consequent increased risk of HIV transmission and also increased morbidity and mortality. Reinforcement of adherence counseling sessions, intensification of patient tracking especially for patients with comorbidities, transfer of patients in suburbs to health facilities closer to their areas of residence will be important to curb LTFU rates and improve on retention of patients LTFU.
Highlights
One of the most difficult problems to resolve for public health in general and infectious diseases, in particular, has been the Human immunodeficiency virus infection and acquired immunodeficiency syndrome (HIV/AIDS) pandemic
Wherever there was more than 1 participant who matched from the controls list, the antiretroviral therapy (ART) numbers of such participants were input in Excel® and a random ranking done, and the first ranked participant was used as the definitive control participant for that case
The results show that the further the distance from the health facility, the greater the chance of being a loss to follow-up client
Summary
One of the most difficult problems to resolve for public health in general and infectious diseases, in particular, has been the Human immunodeficiency virus infection and acquired immunodeficiency syndrome (HIV/AIDS) pandemic. According to United Nations Programme on HIV/ AIDS (UNAIDS), about 36.9 million people are living with HIV worldwide [1]. More than 51% of AIDS-related deaths were averted between 2004 and 2017 due to the use of ART [1]. The use of antiretroviral medication has revolutionized HIV/AIDS. HIV remains one of the major public health issues in Cameroon. Progress has been made in attaining the 9090-90 according to the UNAIDS target, the Loss to follow-up (LTFU) remains a significant challenge to attain the second and third 90. There is a gap of information concerning assessing predictors and determinants of LTFU in the Cameroonian setting taking into consideration psychosocial, economic, cultural, financial, and treatment-related factors. This study seeks to assess and evaluate the determinants and predictors of LTFU among patients enrolled for treatment in the Centre Hospitalier Essos (CHE), Cameroon
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