High Loss to Followup and Early Mortality Create Substantial Reduction in Patient Retention at Antiretroviral Treatment Program in North-West Ethiopia

Table 4

Mortality, loss to followup, and retention by calendar year at university of Gondar Hospital ART program, between March 2005 and August 2010.

Cohort of patients on ART	Patients representing the cohort (a)		^§Death		^§Lost to followup		^§Attrition no. (%)	^§Retention (%) no. (%)	^§Transfer out no. (%)	^§Actual retention to the facility no. (%)
		Person-year (b)	No. of deaths (c)	Rate per 100 PYO (95% CI)	No. LTF (e)	Rate per 100 PYO (95% CI)
				^¥(𝐝)=𝐜/𝐛		^¥(𝐟)=𝐞/𝐛	^¥(𝐟)=(𝐜+𝐞)/𝐚	^¥(𝐠)=(𝟏−𝐟)/𝐚		^¥(𝐢)=(𝐠−𝐡)/𝐛
2005	383	149.5	5	3.3 (1.4–8.0)	19	12.7 (8.1–19.9)	24 (6.3)	359 (93.7)	2 (0.5)	357 (93.21)
2006	1024	721.3	30	4.2 (2.9–5.9)	79	11.0 (8.8–13.7)	109 (10.6)	915 (89.4)	37 (3.6)	878 (85.74)
2007	1727	1809.1	49	2.7 (2.0–3.6)	144	8.0 (6.8–9.4)	193 (11.2)	1534 (88.8)	104 (6.0)	1430 (82.80)
2008	2047	3217.8	52	1.6 (1.2–2.1)	184	5.7 (4.9–6.6)	236 (11.5)	1811 (88.5)	114 (5.6)	1697 (82.90)
2009	2075	4659.3	62	1.3 (1.0–1.7)	91	2.0 (1.6–2.4)	153 (7.4)	1922 (92.6)	138 (6.7)	1784 (85.97)
2010	1876	5354.1	18	0.3 (0.2–0.5)	22	0.4 (0.3–0.6)	40 (2.1)	1916 (97.2)	33 (1.8)	1791 (95.47)
Overall	3012	6383.2	216	3.4 (3.0–3.9)	^†539	8.4 (7.8–9.2)	755 (25.5)	1815 (60.3)	430 (14.3)	1385 (46.0)

^§Death—when confirmed and recorded in the patient card; Lost to followup—if more than three months late for a scheduled visit, and if the tracing team was unable to get information; Transfer-outs—patients who got written referral form to another facility; Attrition—discontinuation of ART for reasons related to death and loss to follow-up; Retention to care—those patients known to be alive and receiving ART; Actual retention—patients actually retained in the program that do not consider transfer out. ^¥Incidence mortality and loss to followup are calculated by dividing events at each cohort by the corresponding PYO. Attrition rate is numbers of death plus LTF divided by patients representing the cohort. Retention is calculated total patients representing the cohort minus attrition divided by total patients representing the cohort. ^†ART—Antiretroviral Therapy; UoG—University of Gondar; PYO-Person—years of observation; LTF—lost to followup.