Retention and predictors of attrition among patients who started antiretroviral therapy in Zimbabwe’s national antiretroviral therapy programme between 2012 and 2015

• DOI: 10.1371/journal.pone.0222309
• Publication Date: 2020-01-07T18:06:14Z
• Authors: Richard Makurumidze; Tsitsi Mutasa-Apollo; Tom Decroo; Regis C. Choto; Kudakwashe C. Tak...; Janet Dzangare; Lutgarde Lynen; Wim Van Damme; James Hakim; Tapuwa Magure; Owen Mugurungi; Simbarashe Rusaka...
• Keywords: Attrition; Lost to follow-up

Background The last evaluation to assess outcomes for patients receiving antiretroviral therapy (ART) through the Zimbabwe public sector was conducted in 2011, covering 2007–2010 cohorts. reported retention at 6, 12, 24 and 36 months were 90.7%, 78.1%, 68.8% 64.4%, respectively. We report findings of a follow-up 2012–2015 cohorts implementation impact recommendations from this prior evaluation. Methods A nationwide retrospective study 2016. Multi-stage proportional sampling used select health facilities participants records. data extracted patient manual records included demographic, baseline clinical characteristics (active on treatment, died, transferred out, stopped ART lost (LTFU)) months. analysed using Stata/IC 14.2. Retention estimated survival analysis. predictors associated with attrition determined multivariate Cox regression model. Results total 3,810 recruited study. median age years 35 (IQR: 28–42). Overall, increased 92.4% (p-value = 0.060), 86.5% (p-value<0.001), 79.2% (p-value<0.001) 74.4% LTFU accounted 98% attrition. Being an adolescent or young adult (15–24 years) (vs adult;1.41; 95% CI:1.14–1.74), children (<15years) adults; aHR 0.64; CI:0.46–0.91), care primary facility central provincial facility; 1.23; CI:1.01–1.49), having initiated between 2014–2015 2012–2013; aHR1.45; 95%CI:1.24–1.69), WHO Stage IV I-III; aHR2.06; 95%CI:1.51–2.81) impaired functional status normal status; aHR1.25; 95%CI:1.04–1.49) predicted Conclusion overall higher comparison previous Further studies understand why found be are warranted. Implementation strategies managing advanced HIV disease, differentiated adolescents adults tracking clients should prioritised further improve retention.