FACTORS ASSOCIATED WITH LOSS TO FOLLOW UP OF ADULT PATIENTS LIVING WITH HIV IN KIAMBU COUNTY AND REFERRAL HOSPITAL, KIAMBU COUNTY, KENYA

Abstract

Purpose: The main objective of this study was to determine the factors associated with loss to follow up and its effects on treatment adherence among HIV positive patients in Comprehensive Care Clinic in Kiambu County Referral Hospital, Kiambu County.

Methodology: This was a descriptive cross sectional study conducted in Kiambu County referral hospital. HIV positive adult patients enrolled in care and documented to have been lost to follow up according to case definition were recruited as participants. A list was generated from the facility's database to calculate a sample size of 327. Random sampling was used to get patients who met the inclusion criteria. Structured questionnaires administered to participants were used and resultant data was coded, cleaned, sorted and analyzed using Statistical Package for Social Sciences version 17. Participants were called on phone to the hospital Comprehensive care clinic and those not reachable on phone residing within the catchment area were visited in their homes. Results: The study found that a third all patients could not be traced by the phone call to the patients or to the treatment supporter or by physical home visit and could therefore their true status was not identified. A proportion of 12.9% classified as lost to follow up were actually dead while 4.3% of files of patient classified as lost were not physically found in the hospital records. Those who were confirmed alive were 69.6% from whom 25.5% had discontinued with care, 41.6% had transferred out and 32.9 % had self- transferred to other facilities where they were continuing with care. The rate of LFTU was found to be 16% against a target of a 10% maximum rate. There is the need to strengthen mechanisms to capture details on deaths as they occur, improve linkage to other facilities, improve on documentation of all patient data including contact and transfer details.