Abstract:
Background: Ethiopia has achieved a rapid scale-up of ART services since the introduction of the free ART program in 2005. High levels of patient retention are critical to the long-term success of ART scale-up program and for the ultimate improvement of survival and quality of life among HIV patients who initiated ART. This review attempts to collate and document available data on ART retention in the country.
Objective: The review aims to provide an estimate of the level of ART retention in Ethiopia for the period 2006-2016.
Methods: The reference sources for this review were PUBMED, DOJI, Cochrane Database of Systematic reviews, Google scholar, ISA abstract archives and gray literatures. Studies that reported levels of ART retention based on observational retrospective cohorts of patients in Ethiopia were included. Average pooled retention proportions for 6, 12, 24, 60 months and total retention proportions following the initiation of ART were estimated using meta-analysis random effect model. RESULTS: The review evaluated 30 studies that were based on primary data and fulfilled the inclusion criteria set for this review. These studies combined included 325,108 patients who were ever started on ART in different geographic areas in Ethiopia. Estimated average pooled ART retention proportions at 6-month was 0.858 (95% CI: 0.831, 0.885). The corresponding 12 months ART retention proportion was a little bit lower at 0.807, (95% CI: 0.772, 0.841). The ART retention proportions were 0.746 and 0.705, respectively, at 24 and 60 months following initiation of ART.
Conclusions & Recommendations: The 0.807 proportion ART retention at 12 months estimated by this review can be considered fairly high although it is significantly lower than the 0.860 thresholds recommended by the World Health Organization (WHO). Further improvement in retention is warranted in order to achieve the at most possible impact of ART on patients’ survival and quality of life.
......................................... Thesis available at ACIPH Library