Loss to follow-up of patients in HIV care in Burundi: A retrospective cohort study

Clement Nshimirimana, Aimé Ndayizeye, Tom Smekens, Bea Vuylsteke

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Abstract

OBJECTIVE: The objective was to assess the loss to follow-up (LTFU) rates and associated factors amongst patients in HIV care in Burundi.

METHODS: We conducted a retrospective cohort study in HIV-positive patients aged ≥15 years who started antiretroviral therapy (ART) between January 2015 and July 2020, with 31 December 2020 as the end point. The outcome of LTFU was defined as failure of a patient to report for drug refill within 90 days from the last appointment. Study data were extracted from the national AIDS Info database. The LTFU proportion was determined using the Kaplan-Meier method with the log-rank test, whereas LTFU risk factors were explored using the Cox regression model.

RESULTS: A total of 29,829 patients on ART were included in the analysis. Cumulative incidence of LTFU was 2.3% at 12 months, 6.5% at 24 months, 12.7% at 36 months, 19.0% at 48 months, 24.1% at 60 months and 25.3% at 72 months. The overall LTFU incidence rate was 11.2 per 100 person-years of observation. The risk of LTFU was higher amongst patients who started ART after 2016 (adjusted hazard ratio [aHR] 1.75, 95% confidence interval [CI] 1.65-1.85) or within 7 days after diagnosis (aHR 1.27, 95% CI 1.21-1.35).

CONCLUSION: Our findings demonstrate the relatively high incidence of LTFU in the Burundi HIV programme. Interventions targeting patients with risk factors for LTFU are particularly necessary.

Original languageEnglish
JournalTropical Medicine and International Health
ISSN1360-2276
DOIs
Publication statusE-pub ahead of print - 12-Apr-2022

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