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BMJ Open. 2017 Jul 17;7(7):e016864. doi: 10.1136/bmjopen-2017-016864.

The magnitude of, and factors associated with, loss to follow-up among patients treated for sexually transmitted infections: a multilevel analysis.

Author information

1
College of Health Science, Mekelle University, Tigray, Ethiopia.
2
Addis Continental Institute of Public Health, Addis Ababa, Ethiopia.
3
Addis Ababa University, Addis Ababa, Ethiopia.

Abstract

OBJECTIVES:

The loss to follow-up (LTFU) among patients attending care for sexually transmitted infections (STIs) in Sub-Saharan Africa is a major barrier to achieving the goals of the STI prevention and control programme. The objective of this study was to investigate individual- and facility-level factors associated with LTFU among patients treated for STIs in Ethiopia.

METHODS:

A prospective cohort study was conducted among patients attending care for STIs in selected facilities from January to June 2015 in the Tigray region of Ethiopia. LTFU was ascertained if a patient did not present in person to the same facility within 7 days of the initial contact. Multilevel logistic regression was used to identify factors associated with LTFU.

RESULTS:

Out of 1082 patients, 59.80% (647) were LTFU. The individual-level factors associated with LTFU included having multiple partners (adjusted OR (AOR) 2.89, 95% CI 1.74 to 4.80), being male (AOR 2.23, 95% CI 1.63 to 3.04), having poor knowledge about the means of STI transmission (AOR 2.08, 95% CI 1.53 to 2.82), having college level education (AOR 0.38, 95% CI 0.22 to 0.65), and low perceived stigma (AOR 0.60, 95% CI 0.43 to 0.82). High patient flow (AOR 3.06, 95% CI 1.30 to 7.18) and medium health index score (AOR 2.80, 95% CI 1.28 to 6.13) were facility-level factors associated with LTFU.

CONCLUSIONS:

Improving patient retention in STI follow-up care requires focused interventions targeting those who are more likely to be LTFU, particularly patients with multiple partners, male index cases and patients attending facilities with high patient flow.

KEYWORDS:

loss to follow-up; multilevel analysis; partner notification; sexually transmitted infections

PMID:
28716795
PMCID:
PMC5726144
DOI:
10.1136/bmjopen-2017-016864
[Indexed for MEDLINE]
Free PMC Article

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