Defaulting from Care and Quality of Life of Adults on Anti-Retroviral Treatment Program in Owo, Ondo State, Nigeria: A Case-Control Study

Ilesanmi, Olayinka Stephen; Adeoye, Ikeola A.; Fawole, Olufunmilayo I.

doi:10.30476/jhsss.2020.88290.1141

Document Type : Original Article

Authors

¹ Department of Community Medicine, College of Medicine, University of Ibadan

² Department of Community Medicine, University College Hospital, Ibadan

³ Department of Epidemiology and Medical Statistics, College of Medicine, University of Ibadan

https://doi.org/10.30476/jhsss.2020.88290.1141

Abstract

Background: In Nigeria, over 600,000 people living with HIV/AIDS (PLWHA) are on antiretroviral therapy (ART) as of 2020. Defaulters after commencing ART range between 10-36%. This study identified the factors associated with default from ART and quality of life among PLWHA.
Methods: An unmatched case-control study was conducted among 102 cases and 204 controls at the Federal Medical Centre, Owo, Ondo State, Nigeria. Cases were adults on ART who had defaulted from care and missed at least two consecutive appointments in the last year, while controls were adults on ART who had been consistent with clinic attendance for at least one year. Chi-square test, t-test, and binary logistic regressions were used to identify the predictors of default at a 95% confidence interval.
Results:Respondent’s mean age was 41.4±10.3 years while 61.4% of the respondents were females. ART role in reducing viral load was described correctly by 66 (64.7%) cases and 155 (76.0%) controls (p=0.04). The quality of life in the physical domain was 15.3± 3.4 among cases and 16.6±3.0 among controls (p=0.001). Defaulting from treatment was associated with non-disclosure of status to a partner (AOR: 2.8; CI 95%: 1.6-4.9), receiving fewer counseling sessions (AOR: 2.3; CI 95%: 1.3-4.2), poor perception of the quality of health care services (AOR: 2.6; CI 95%: 1.4-4.7), suboptimal quality of life (AOR: 2.7; CI 95%: 1.5- 4.8) and the richer wealth index (AOR: 1.8; CI 95%: 1.01-3.18).
Conclusion: Inclusion of discussions on disclosure during counseling sessions was recommended to reduce default.

Keywords

References

1.Bloomfield GS, Alenezi F, Barasa FA, Lumsden R, Mayosi BM, Velasquez EJ. Human Immunodeficiency Virus and Heart Failure in Low- and Middle-Income Countries: A State-of-the-Art Review. Journal of the American College of Cardiology Heart Failure. 2015:3(8):579-590.

2.Kempton J, Hill A, Levi JA, Heath K, Pozniak A. Most new HIV infections, vertical transmissions, and AIDS-related deaths occur in lower-prevalence countries.Journal of Virus Eradication. 2019;5(2):92-101.

3.Patel P, Rose CE, Collins PY, Nuche-Berenguer B, Sahasrabuddhe VV, Peprah E, Vorkoper S, Pastakia SD, Rausch D, Levitt NS, NIH HIV/NCD Project Disease Condition Technical Operating Group.AIDS. 2018;1; 32(Suppl 1): S5–S20. doi: 10.1097/QAD.0000000000001888

4.Dadonaite B. Antiretroviral therapy has saved millions of lives from AIDS and could save more. Our World in Data. December 2019. Available from: https://ourworldindata.org/art-lives-saved. Accessed 30 August 2020.08.31.

5.Ulett KB, Willig JH, Lin H-Y, Routman JS, Abroms S, Allison J, Chatham A, Raper JL, Saag MS, Mugavero MJ: The Therapeutic Implications of Timely Linkage and Early Retention in HIV Care. AIDS patient care and STDs.2009, 23(1):41-49.

6.Oliveira MI, de Souza Junior VR, de Lacerda Vidal CF, de Araujo PS. Virologic suppression in response to antiretroviral therapy despite extensive resistance within HIV-1 reverse transcriptase after the first virologic failure. BMC Infectious Diseases. 2018; 18:514.

7.Miller CM, Ketlhapile M, Rybasack-Smith H, Rosen S. Why are antiretroviral treatment patients lost to follow-up? A qualitative study from South Africa. Tropical Medicine and International Health . 2010 ;15(s1):48–54.

8.Dalhatu I, Onotu D, Odafe S, Abiri O, Debem H, Agolory S, Shiraishi RW, Auld AF, Swaminathan M, Dokubo K, Ngige E, Asadu C, Abatta E, Ellerbrock TV. Outcomes of Nigeria's HIV/AIDS Treatment Program for Patients Initiated on Antiretroviral Treatment between 2004-2012. PLoS One. 2016; 11(11): e0165528.

9.Umeokonkwo CD, Onoka CA, Agu PA, Ossai EN, Balogun MS, Ogbonnaya LU. Retention in care and adherence to HIV and AIDS treatment in Anambra State Nigeria. BMC Infectious Diseases. 2019;654.

10.Kirkwood BR (ed.): Essentials of Medical Statistics, 2nd edn: Blackwell Science Ltd; 2003.

11.Meloni ST, Chang C, Chaplin B, Rawizza H, Jolayemi O, Banigbe B, Okonkwo P, Kanki P: Time-Dependent Predictors of Loss to Follow-Up in a Large HIV Treatment Cohort in Nigeria. Open Forum Infectious Diseases.2014, 1(2):1-11.

12.WHOQOL-HIV BREF. Mental Health: Evidence and Research Department of Mental health and Substance dependence. Available from: http://www.who.int/mental_health/publications/whoqol_hiv_bref.pdf (accessed 21/09/2020)

13.Akinboro AO, Akinyemi SO, Olaitan PB, Raji AA, Popoola AA, Awoyemi OR, Ayodele OE. Quality of life of Nigerians living with human immunodeficiency virus. Pan Afr Med J. 2014 Jul 22;18:234. doi: 10.11604/pamj.2014.18.234.2816. PMID: 25426192; PMCID: PMC4242044.

14.IBM SPSS Statistics for Windows: Version 21.0. IBM Corp. Released 2012. Armonk, NY: IBM Corp.

15.Wester C, Kim S, Bussmann H, Avalos A, Ndwapi N, Peter TF, et al.: Initial response to highly active antiretroviral therapy in HIV-1C-infected adults in a public sector treatment program in Botswana.Journal of Acquired Immune Deficiency Syndrome.2005, 40:336-343.

16.Wools-Kaloustian K, Kimaiyo S, Diero L, Siika A, Sidle J, Yiannoutsos CT, et al.: Viability and effectiveness of large-scale HIV treatment initiatives in sub-Saharan Africa: experience from Western Kenya. AIDS.2006, 20:41-48.

17.Ferradini L, Jeannin A, Pinoges L, Izopet J, Odhiambo D, Mankhambo L, Karungi G, Szumilin E, Balandine S, Fedida G et al: Scaling up of highly active antiretroviral therapy in a rural district of Malawi: an effectiveness assessment. Lancet 2006, 367:1335-1342.

18.Massaquoi M, Zachariah R, Manzi M, Pasulani O, Misindi D, Mwagomba B, Bauernfeind A, Harries AD: Patient retention and attrition on antiretroviral treatment at the district level in rural Malawi. Transactions of the Royal Society of Tropical Medicine and Hygiene.2009, 103(6):594-600.

19.Kwong-Leung Yu J, Tok T-S, Tsai J-J, Chang W-S, Dzimadzi RK, Yen P-H, Makombe SD, Nkhata A, Schouten EJ, Kamoto K et al: What Happens to Patients on Antiretroviral Therapy Who Transfer Out to Another Facility? PLoS ONE.2008, 3(4):e2065.

20.WHOQOL: Measuring Quality of Life. Available from http://www.who.int/healthinfo/survey/whoqol-qualityoflife/en/(Accessed 26/09/2020)]

21.Olowookere SA, Fatiregun AA, Adewole IF: Knowledge and attitudes regarding HIV/AIDS and antiretroviral therapy among patients at a Nigerian treatment clinic. Journal of i=Infection in Developing Countries. 2012, 6(11):809-816.

22.Terblanche LM, Stellenberg EL: Patient knowledge of HIV and its treatment in South Africa. African Journal of Primary Health Care & Family Medicine. 2014, 6(1):1-7.

23.Tweya H, Gareta D, Chagwera F, Ben-Smith A, Mwenyemasi J, Chiputula F, Boxshall M, Weigel R, Jahn A, Hosseinipour M et al: Early active follow-up of patients on antiretroviral therapy (ART) who are lost to follow-up: the 'Back-to-Care' project in Lilongwe, Malawi. Tropical Medicine and International Health. 2010;15(Suppl 1):82-89.

24.Kranzer K, Lewis JJ, Ford N, Zeinecker J, Orrell C, Lawn SD, Bekker LG, Wood R: Treatment interruption in a primary care antiretroviral therapy program in South Africa: cohort analysis of trends and risk factors. Journal of Acquired Immune Deficiency Syndrome.2010, 55(3):e17-23.

25.Yaya I, Landoh DE, Saka B, Patchali PM, Wasswa P, Aboubakari A, N'Dri MK, Patassi AA, Kombaté A, Pitche P. Predictors of adherence to antiretroviral therapy among people living with HIV and AIDS at the regional hospital of Sokodé, Togo.BMC Public Health.2014; 14(1308).

26.Mugisha K, Ocero A, Semafumu E, Ciccio L, Muwanika RF, Otim J, Makumbi M: Retention of HIV Positive Persons in Antiretroviral Therapy Programs in Post-Conflict Northern Uganda-Baseline Survey of 17 Health Units. 2009.

27.Uchendu OC, Ilesanmi OS, Olumide AE: Factors influencing the choice of health care providing facility among workers in a local government secretariat in South Western Nigeria. Annals of Ibadan Postgraduate Medicine.2013, 11(2):87-95.

28.Asefa T, Taha M, Dejene T, Dube L: Determinants of defaulting from antiretroviral therapy treatment in Nekemte Hospital, Eastern Wollega Zone, Western Ethiopia. Public Health Research. 2013, 3(5):130-135.

29.Fox AM: The Social Determinants of HIV Serostatus in Sub-Saharan Africa: An Inverse Relationship Between Poverty and HIV? Public Health Reports 2010, 125(Suppl 4):16-24.

30.Sam TS, Hutton HE, Lau B, McCaul ME, Keruly J, Moore R, et al., Antiretroviral Therapy Use, Medication Adherence, and Viral Suppression among PLWHA with Panic Symptoms. AIDS Behav. 2015; 19(11): 2049–2056. doi: 10.1007/s10461-015-1064-4

Journal of Health Sciences & Surveillance System

Defaulting from Care and Quality of Life of Adults on Anti-Retroviral Treatment Program in Owo, Ondo State, Nigeria: A Case-Control Study

References

References

Volume 9, Issue 4
October 2021
Pages 226-234

Defaulting from Care and Quality of Life of Adults on Anti-Retroviral Treatment Program in Owo, Ondo State, Nigeria: A Case-Control Study

References

References

Volume 9, Issue 4October 2021Pages 226-234

Volume 9, Issue 4
October 2021
Pages 226-234