RESEARCH PAPER
Defaulting from antiretroviral therapy and associated factors among HIV/AIDS patients in public hospitals of Eastern Zone, Tigray, Ethiopia, 2020: a cross-sectional study
1
Adigrat University, Adigrat, Ethiopia
Submission date: 2023-04-25
Final revision date: 2023-07-26
Acceptance date: 2023-09-12
Publication date: 2024-11-30
HIV & AIDS Review 2024;23(4):314-322
KEYWORDS
TOPICS
ABSTRACT
Background:
Globally, over 76 million people have been infected with human immunodeficiency virus (HIV), and the infection has contributed to more than 35 million deaths since its emergence. Studies revealed that in developing countries, defaulting patients were outnumbering patients who were known to have died. The burden of defaulting and associated factors among adults receiving antiretroviral therapy (ART) is lacking in this particular study area. Therefore, this study aimed to assess the prevalence of defaulting and associated factors among adult HIV/AIDS patients receiving antiretroviral therapy in Eastern Zone, Tigray, Ethiopia.
Material and methods:
A structured questionnaire was employed to collect data from 501 study participants through an interview. The required sample size was determined with a single population proportion formula. Participants were selected using a systematic random sampling method. Data were entered and analyzed with Statistical Package for Social Science (SPSS) version 22. Multivariable logistic regression analysis was used to obtain factors, with p-value < 0.05.
Results:
The mean age of participants was 40.97 (± 9.35) years. The prevalence of defaulting was 25% (95% CI: 21.2-29.1%). Side effects of ART, mental instability, poor adherence to ART, and high pill burden were independently associated with defaulting from ART.
Conclusions:
The results of the study indicated that defaulting was high. Furthermore, participants with high pill burden, drug toxicity, mental instability, and poor ART adherence were more likely to default from the treatment. Healthcare providers should advise HIV patients to improve adherence to treatment, and highlight its importance as a priority issue.
Globally, over 76 million people have been infected with human immunodeficiency virus (HIV), and the infection has contributed to more than 35 million deaths since its emergence. Studies revealed that in developing countries, defaulting patients were outnumbering patients who were known to have died. The burden of defaulting and associated factors among adults receiving antiretroviral therapy (ART) is lacking in this particular study area. Therefore, this study aimed to assess the prevalence of defaulting and associated factors among adult HIV/AIDS patients receiving antiretroviral therapy in Eastern Zone, Tigray, Ethiopia.
Material and methods:
A structured questionnaire was employed to collect data from 501 study participants through an interview. The required sample size was determined with a single population proportion formula. Participants were selected using a systematic random sampling method. Data were entered and analyzed with Statistical Package for Social Science (SPSS) version 22. Multivariable logistic regression analysis was used to obtain factors, with p-value < 0.05.
Results:
The mean age of participants was 40.97 (± 9.35) years. The prevalence of defaulting was 25% (95% CI: 21.2-29.1%). Side effects of ART, mental instability, poor adherence to ART, and high pill burden were independently associated with defaulting from ART.
Conclusions:
The results of the study indicated that defaulting was high. Furthermore, participants with high pill burden, drug toxicity, mental instability, and poor ART adherence were more likely to default from the treatment. Healthcare providers should advise HIV patients to improve adherence to treatment, and highlight its importance as a priority issue.
REFERENCES (35)
1.
UNAIDS. Fact sheet: World AIDS Day 2019 – global HIV statistics. 2019. Available at: https://www.unaids.org/en/reso....
2.
UNAIDS. Fact sheet-latest statistics on the status of the AIDS epidemic. 2017. Available at: https://www.unaids.org/en/reso... (Accessed: 19.12.2019).
3.
Kibret GD, Ferede A, Leshargie CT, Wagnew F, Ketema DB, Alebel A. Trends and spatial distributions of HIV prevalence in Ethiopia. Infect Dis Poverty 2019; 8: 90. DOI: 10.1186/s40249-019-0594-9.
4.
Gelassa FR, Birhanu A, Shibiru A, Nagari SL, Jabena DE. Undiagnosed status and associated factors of hypertension among adults living in rural of central, Ethiopia, 2020: uncovering the hidden magnitude of hypertension. PLoS One 2022; 17: e0277709. DOI: 10.1371/journal.pone.0277709.
5.
Teshome DF, Balcha SA, Ayele TA, Atnafu A, Gelaye KA. Undiagnosed hypertension and its determinants among hypertensive patients in rural districts of northwest Ethiopia: a mediation analysis. BMC Health Serv Res 2023; 23: 222. DOI: 10.1186/s12913-023-09212-1.
6.
Zewudie BT, Tenaw SG, Solomon M, Mesfin Y, Abebe H, Mekonnen Z, et al. The magnitude of undiagnosed hypertension and associated factors among HIV-positive patients attending antiretroviral therapy clinics of Butajira General Hospital, Gurage Zone, Southern Ethiopia. SAGE Open Med 2022; 10: 20503121221094454. DOI: 10.1177/20503121221094454.
7.
Mogas SB, Tesfaye T, Zewde B, Tesfaye Y, Kebede A, Tadesse M, et al. Burden of undiagnosed hypertension among adults in urban communities of Southwest Ethiopia. Integr Blood Press Control 2021; 14: 69-76.
8.
Megerssa Y, Wolde M, Kinde S, Reja A. Prevalence of undiagnosed diabetes mellitus and its risk factors in selected institutions at Bishoftu Town, East Shoa, Ethiopia. J Diabetes Metab 2013; S12: 008. DOI: 10.4172/2155-6156.S12-008.
9.
Abebe SM, Berhane Y, Worku A, Getachew A. Prevalence and associated factors of hypertension: a crossectional community based study in Northwest Ethiopia. PLoS One 2015; 10: e0125210. DOI: 10.1371/journal.pone.0125210.
10.
Undavalli VK, Praveen M, Narni H. Prevalence of undiagnosed hypertension: a public health challenge. Int J Community Med Public Health 2018; 5: 1366-1370.
11.
Dereje N, Earsido A, Temam L, Abebe A. Uncovering the high burden of hypertension and its predictors among adult population in Hosanna town, southern Ethiopia: a community-based cross-sectional study. BMJ Open 2020; 10: e035823. DOI: 10.1136/bmjopen-2019-035823.
12.
Erratum: Burden of undiagnosed hypertension among adults in urban communities of Southwest Ethiopia [Corrigendum]. Integr Blood Press Control 2021; 14: 87. DOI: 10.2147/IBPC.S323336.
13.
Tesfaye T. Assessment of the prevalence of hypertension and associated factors among Ethiopian Federal Police Officers Addis Ababa, Ethiopia: a community based cross-sectional study. EC Cardiology 2017; 2: 278-286.
14.
Dereje N, Earsido A, Abebe A, Temam L. Undiagnosed and diagnosed hypertension in a community setting at Hosanna town: uncovering the burden. BioRxiv 2019; 560748. DOI: https://doi.org/10.1101/560748.
15.
Ayalew TL, Wale BG, Zewudie BT. Burden of undiagnosed hypertension and associated factors among adult populations in Wolaita Sodo Town, Wolaita Zone, Southern Ethiopia. BMC Cardiovasc Disord 2022; 22: 293. DOI: 10.1186/s12872-022-02733-3.
16.
Asefa T, Taha M, Dejene T, Dube L. Determinants of defaulting from antiretroviral therapy treatment in Nekemte Hospital, Eastern Wollega Zone, Western Ethiopia. Publ Health Res 2013; 3: 130-135.
17.
Deribe K, Hailekiros F, Biadgilign S, Amberbir A, Beyene BK. Defaulters from ante retroviral treatment in Jimma University Specialized Hospital, South East Ethiopia. Trop Med Int Health 2008; 13: 328-333.
18.
Daniel OJ, Oladapo OT, Ogundahunsi OA, Ogundahunsi S, Ogun SA, Odusoga OA. Default from anti-retroviral treatment programme in Sagamu, Nigeria. Afr J Biomed Res 2008; 11: 221-224.
19.
Dejenie M, Kerie S, Reba K. Undiagnosed hypertension and associated factors among bank workers in Bahir Dar City, Northwest, Ethiopia, 2020. A cross-sectional study. PLoS One 2021; 16: e0252298. DOI: 10.1371/journal.pone.0252298.
20.
Wachamo D, Geleta D, Woldesemayat EM. Undiagnosed hypertension and associated factors among adults in Hawela Tula Sub-City, Hawassa, Southern Ethiopia: a community-based cross-sectional study. Risk Manag Healthc Policy 2020; 13: 2169-2177.
21.
Essa E, Shitie D, Yirsaw MT, Wale MZ. Undiagnosed hypertension and associated factors among adults in Debre Markos town, North-West Ethiopia: a community-based cross-sectional study. SAGE Open Med 2022; 10: 20503121221094223. DOI: 10.1177/20503121221094223.
22.
Yuan Y, L’italien G, Mukherjee J, Iloeje UH. Determinants of discontinuation of initial highly active antiretroviral therapy regimens in a US HIV‐infected patient cohort. HIV Med 2006; 7: 156-162.
23.
Di Biagio A, Cozzi-Lepri A, Prinapori R, Angarano G, Gori A, Quirino T, et al. Discontinuation of initial antiretroviral therapy in clinical practice: moving toward individualized therapy. J Acquir Immune Defic Syndr 2016; 71: 263-271.
24.
Megerso A, Garoma S, Eticha T, Workineh T, Daba S, Tarekegn M, et al. Predictors of loss to follow-up in antiretroviral treatment for adult patients in the Oromia region, Ethiopia. HIV AIDS (Auckl) 2016; 8: 83-92.
25.
Gesesew HA, Ward P, Woldemichael K, Mwanri L. Prevalence, trend and risk factors for antiretroviral therapy discontinuation among HIV-infected adults in Ethiopia in 2003-2015. PLoS One 2017; 12: e0179533. DOI: 10.1371/journal.pone.0179533.
26.
Seifu W, Ali W, Meresa B. Predictors of loss to follow up among adult clients attending antiretroviral treatment at Karamara general hospital, Jigjiga town, Eastern Ethiopia, 2015: a retrospective cohort study. BMC Infect Dis 2018; 18: 280. DOI: 10.1186/s12879-018-3188-4.
27.
Federal HIV/AIDS Prevention and Control Office (FHAPCO). HIV prevention in Ethiopia: national road map 2018-2020. FHAPCO; 2018. Available at: https://hivpreventioncoalition....
28.
Fiseha T, Belete AG, Dereje H, Dires A. Hypertension in HIV-infected patients receiving antiretroviral therapy in Northeast Ethiopia. Int J Hypertens 2019; 2019: 4103604. DOI: 10.1155/2019/4103604.
29.
Yabeyu AB, Haile KT, Belay YB, Tegegn HG. Limited public knowledge of chronic kidney disease in a resource-limited setting: a cross-sectional study. Int J Gen Med 2022; 15: 4997-5003.
30.
Kasumu L, Balogun M. Knowledge and attitude towards antiretroviral therapy and adherence pattern of HIV patients in southwest Nigeria. Int J Infect Control 2014; 10. DOI: https://doi.org/10.3396/ijic.v....
31.
Menyanu E, Russell J, Charlton K. Dietary sources of salt in low-and middle-income countries: a systematic literature review. Int J Environ Res Public Health 2019; 16: 2082. DOI: 10.3390/ijerph16122082.
32.
SeyedAlinaghi S, Paydary K, Kazerooni PA, Hosseini M, Sedaghat A, Emamzadeh-Fard S, et al. Evaluation of stigma index among people living with HIV/AIDS (PLWHA) in six cities in iran. Thrita 2013; 2: 69-75.
33.
Brinkhof MW, Pujades-Rodriguez M, Egger M. Mortality of patients lost to follow-up in antiretroviral treatment programmes in resource-limited settings: systematic review and meta-analysis. PLoS One 2009; 4: e5790. DOI: 10.1371/journal.pone.0005790.
34.
Yu JKL, Chen SCC, Wang KY, Chang CS, Makombe SD, Schouten EJ, et al. True outcomes for patients on antiretroviral therapy who are “lost to follow-up” in Malawi. Bull World Health Organ 2007; 85: 550-554.
35.
Micek MA, Gimbel-Sherr K, Baptista AJ, Matediana E, Montoya P, Pfeiffer J, et al. Loss to follow-up of adults in public HIV care systems in Mozambique: identifying obstacles to treatment. J Acquir Immune Defic Syndr 2009; 52: 397-405.
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