Magnitude and Predictors of Anti-Retroviral Treatment (ART) Failure in Private Health Facilities in Addis Ababa, Ethiopia

The public health approach to antiretroviral treatment management encourages the public private partnership in resource limited countries like Ethiopia. As a result, some private health facilities are accredited to provide antiretroviral treatment free services. Evidence on magnitude and predictors...

Celý popis

Uloženo v:
Podrobná bibliografie
Vydáno v:PloS one Ročník 10; číslo 5; s. e0126026
Hlavní autoři: Teshome Yimer, Yesunesh, Yalew, Alemayehu Worku
Médium: Journal Article
Jazyk:angličtina
Vydáno: United States Public Library of Science 06.05.2015
Public Library of Science (PLoS)
Témata:
Acquired immune deficiency syndrome
Adolescent
Adult
AIDS
Anti-HIV Agents - therapeutic use
Antiretroviral agents
Antiretroviral drugs
Clients
Cohort Studies
Confidence intervals
Diagnosis
Disease resistance
Drug resistance
Ethiopia
Failure analysis
Female
Health aspects
Health care facilities
Health Facilities
Health services
Highly active antiretroviral therapy
HIV
HIV Infections - drug therapy
HIV Infections - mortality
Hospitals, Private
Human immunodeficiency virus
Humans
Kaplan-Meier Estimate
Male
Medical diagnosis
Medical treatment
Middle Aged
Proportional Hazards Models
Public health
Public private partnerships
Public-Private Sector Partnerships
Regression analysis
Resource management
Retrospective Studies
Risk Factors
Services
Statistical analysis
Survival
Treatment Failure
Young Adult
Ethiopia
Addis Ababa Ethiopia
ISSN:1932-6203, 1932-6203
On-line přístup:Získat plný text
Tagy: Přidat tag
Žádné tagy, Buďte první, kdo vytvoří štítek k tomuto záznamu!
Popis
Shrnutí:The public health approach to antiretroviral treatment management encourages the public private partnership in resource limited countries like Ethiopia. As a result, some private health facilities are accredited to provide antiretroviral treatment free services. Evidence on magnitude and predictors of treatment failure are crucial for timely actions. However, there are few studies in this regard. To assess the magnitude and predictors of ART failure in private health facilities in Addis Ababa, Ethiopia. The study followed retrospective cohort design, with 525 adult antiretroviral treatment clients who started the treatment since October 2009 and have at least six months follow up until December 31, 2013. Kaplan Meier survival analysis and Cox proportional hazard model were used for analysis. Treatment failure, using the three WHO antiretroviral treatment failure criteria, was 19.8%. The immunologic, clinical, and virologic failures were 15%, 6.3% and 1.3% respectively. The mean and median survival times in months were 41.17 with 95% Confidence Interval (CI) [39.69, 42.64] and 49.00, 95% CI [47.71, 50.29] respectively. The multivariate cox regression analysis showed years since HIV diagnosis (Adjusted Hazard Ratio (AHR)=13.87 with 95% CI [6.65, 28.92]), disclosure (AHR=0.59, 95% CI [0.36, 0.96]), WHO stage at start (AHR=1.84, 95% CI [1.16, 2.93]), weight at baseline (AHR=0.58, 95% CI [0.38, 0.89]), and functionality status at last visit (AHR=2.57, 95% CI [1.59, 4.15]) were independent predictors of treatment failure. The study showed that the treatment failure is high among the study subjects. The predictors for antiretroviral treatment failure were years since HIV diagnosis, weight at start, WHO stage at start, status at last visit and disclosure. Facilities need to monitor antiretroviral treatment clients to avoid disease progression and drug resistance.
Bibliografie:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 14
content type line 23
Conceived and designed the experiments: YTY AWY. Performed the experiments: YTY. Analyzed the data: YTY. Contributed reagents/materials/analysis tools: YTY AWY. Wrote the paper: YTY AWY.
Competing Interests: The authors have declared that no competing interests exist.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0126026