Trends in mortality and loss to follow-up in HIV care at the Nkongsamba Regional hospital, Cameroon

• Published in: BMC research notes 2013-12, Vol.6 (1), p.512-512, Article 512
• Main Authors: Bekolo, Cavin Epie, Webster, Jayne, Batenganya, Moses, Sume, Gerald Etapelong, Kollo, Basile
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Ambulatory Care Facilities - statistics & numerical data; Ambulatory Care Facilities - trends; Anti-HIV Agents - therapeutic use; Cameroon - epidemiology; CD4 Lymphocyte Count; Female; Follow-Up Studies; HIV; HIV Infections - drug therapy; HIV Infections - epidemiology; HIV Infections - mortality; HIV Infections - pathology; Hospitals; Human immunodeficiency virus; Humans; Male; Mortality; Proportional Hazards Models; Retrospective Studies; Risk Factors; Studies; Survival Analysis
• ISSN: 1756-0500; 1756-0500
• DOI: 10.1186/1756-0500-6-512

Access to Human Immunodeficiency Virus (HIV) care has been rolled out in Cameroon in the last decade through decentralised delivery of care and timely initiation of free antiretroviral drugs. We sought to describe the evolution of mortality and loss to follow up (LTFU) and their patient-related determinants at an HIV clinic which is facing significant challenges. A retrospective review of point of care data from HIV patients was conducted in June 2012 at Nkongsamba Regional Hospital in Cameroon to establish mortality and LTFU rates. Univariable and multivariable Cox regression models were used to screen for factors associated with the outcomes. Telephone calls were made to trace patients LTFU. Between June 2005 and December 2010, 2388 HIV infected patients were admitted. Of these, 1858 were aged 15 and above and were included in our analysis. Their median age was 36 years (IQR: 30-44) and they were followed up over a total risk period of 3647.3 person-years (pyrs). The overall mortality rate was 34.6 deaths per 1000 pyrs (95% CI: 29.0-41.1) while the overall LTFU rate was 94.6 per 1000 pyrs (95%CI: 85.1-105.1).The mortality rates steadily rose to a peak of 69.6 deaths per 1000 pyrs in 2009 and then fell drastically to 20.6 per 1000 pyrs in 2010. The LTFU rate increased sharply from 29.7 in 2006 to 138.2 in 2007 and remained virtually stable until 2010. The factors associated with mortality were: being male (aHR=2.25, 95% CI: 1.58-3.19), clinical disease progression (aHR=2.0, 95% CI: 1.58-2.53), CD4 count