PMID- 36228004
OWN - NLM
STAT- MEDLINE
DCOM- 20221017
LR  - 20221019
IS  - 1932-6203 (Electronic)
IS  - 1932-6203 (Linking)
VI  - 17
IP  - 10
DP  - 2022
TI  - Incidence and factors associated with being lost to follow-up among people living 
      with HIV and receiving antiretroviral therapy in Nyarugenge the central business 
      district of Kigali city, Rwanda.
PG  - e0275954
LID - 10.1371/journal.pone.0275954 [doi]
LID - e0275954
AB  - BACKGROUND: Lost to follow-up (LTFUP) continues to threaten the sustainability of 
      antiretroviral therapy (ART) benefits and success of ART programs. We determined 
      the incidence and predictors of LTFUP among people living with HIV (PLHIV) on ART 
      in Nyarugenge the Central Business District of Kigali city. METHODS: A cohort of 
      PLHIV who initiated ART in 2018 was retrospectively studied for 24 months. Using 
      health facility records, a person who had no record of contact with the health 
      facility for at least three consecutive months was considered LTFUP. LTFUP 
      incidence rates were computed, and the Fine-Gray's competing risk regression 
      models were used to determine factors associated with time to first LTFUP. 
      Generalized estimating equations (GEEs) were used to analyze repeated measurement 
      outcomes of LTFUP and predictors of LTFUP. RESULTS: Of 950 participants, 581 
      (61.2%) were females and 866 (91.2%) were 15 to 49 years old. From 1,586.1 person 
      years of observation (pyo), 148 participants got LTFUP for 451 times. The 
      incidence rate to first event was 9.4 per 100 pyo (95%CI:7.9-10.9) and 31.8 per 
      100 pyo (95%CI:29.0-34.4) to multiple events. WHO stage, marital status, 
      employment status and person to contact when PLHIV is not reachable were 
      associated with time to first LTFUP event. However, an average participant with a 
      contact person who was not a Community Health Worker (CHW) or a peer educator had 
      higher incidence of LTUP (aIRR = 2.69, 95%CI: 1.43-5.06), an average single 
      patients had higher incidence of LTFUP (aIRR = 1.74, 95%CI: 1.28-2.34) compared 
      to married/co-habiting, and an average self-employed had higher incidence of 
      LTFUP (aIRR = 1.51, 95%CI: 1.14-2.01) compared to participants employed by 
      others. Furthermore, an average PLHIV living out-of-the health facility catchment 
      area had higher incidence of LTFUP (aIRR = 1.55, 95%CI: 1.19-2.01) compared to an 
      average PLHIV living in the health facility catchment area whereas, an average 
      children initiated on first line had lower incidence of LTUP (aIRR = 0.43, 95%CI: 
      0.21-0.86) compared to adults. CONCLUSION: Using CHW and peer educators as 
      contact persons can help to reduce LTFUP while, targeted sensitization and 
      service delivery are needed for single, self-employed and, patients living out of 
      the health facility catchment area.
FAU - Ntabanganyimana, Daniel
AU  - Ntabanganyimana D
AUID- ORCID: 0000-0003-2183-7873
AD  - Rwanda Field Epidemiology and Laboratory Training Program, Department of 
      Epidemiology and Biostatistics, University of Rwanda, Kigali, Rwanda.
AD  - Ministry of Health, Kigali, Rwanda.
FAU - Rugema, Lawrence
AU  - Rugema L
AD  - University of Rwanda/School of Public Health, Kigali, Rwanda.
FAU - Omolo, Jared
AU  - Omolo J
AD  - CGH DGHT, Centers for Disease Control and Prevention, Kigali, Rwanda.
FAU - Nsekuye, Olivier
AU  - Nsekuye O
AD  - Rwanda Field Epidemiology and Laboratory Training Program, Department of 
      Epidemiology and Biostatistics, University of Rwanda, Kigali, Rwanda.
AD  - Rwanda Biomedical Centre, Public Health Surveillance & Emergency Preparedness and 
      Response, Kigali, Rwanda.
FAU - Malamba, Samuel Sewava
AU  - Malamba SS
AD  - CGH DGHT, Centers for Disease Control and Prevention, Kigali, Rwanda.
LA  - eng
PT  - Journal Article
DEP - 20221013
PL  - United States
TA  - PLoS One
JT  - PloS one
JID - 101285081
RN  - 0 (Anti-HIV Agents)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - *Anti-HIV Agents/therapeutic use
MH  - Child
MH  - Female
MH  - *HIV Infections/drug therapy/epidemiology
MH  - Humans
MH  - Incidence
MH  - Lost to Follow-Up
MH  - Male
MH  - Middle Aged
MH  - Retrospective Studies
MH  - Rwanda
MH  - Young Adult
PMC - PMC9562217
COIS- The authors have declared that no competing interests exist.
EDAT- 2022/10/14 06:00
MHDA- 2022/10/18 06:00
PMCR- 2022/10/13
CRDT- 2022/10/13 14:04
PHST- 2022/04/21 00:00 [received]
PHST- 2022/09/26 00:00 [accepted]
PHST- 2022/10/13 14:04 [entrez]
PHST- 2022/10/14 06:00 [pubmed]
PHST- 2022/10/18 06:00 [medline]
PHST- 2022/10/13 00:00 [pmc-release]
AID - PONE-D-22-11720 [pii]
AID - 10.1371/journal.pone.0275954 [doi]
PST - epublish
SO  - PLoS One. 2022 Oct 13;17(10):e0275954. doi: 10.1371/journal.pone.0275954. 
      eCollection 2022.