Original Research Article
Year: 2018 | Month: August | Volume: 8 | Issue: 8 | Pages: 8-20
Predictors of First Line Antiretroviral Therapy (ART) Failure among ART Patients in Gutu District, Masvingo Province, Zimbabwe, 2016
Admire Zikiti1, J. Chideme Maradzika2, Anesu Marume1, Byron Chapoterera1
1Ministry Of Health And Child Care, Zimbabwe : Admire Zikiti, Gutu Rural Hospital,P.O Box 136, Gutu, Masvingo ,Zimbabwe Anesu Marume, Mutasa District , Byron Chapoterera ,St Alberts Hospital, Centenary
2University Of Zimbabwe, Department of Community Medicine, College of Health Sciences, Box A 178 Avondale, Harare, Zimbabwe.
Corresponding Author: J. Chideme Maradzika
Background: First Line ART Failure is one of the challenging programmatic public health problems in HIV response. Surveillance of ART in Gutu district indicated that an increasing number of patients were moving to second line therapy. The aim of this study was to identify predictors of first line ART failure
Methods: A 1:1 case-control study was conducted where 300 ART patients were enrolled into the study who had been on ART for at least 6 months, failed first line ART and had been switched to second line ART. Controls were patients who have been on ART for at least 6 months, failed first line ART and were still on first line interviewer administered questionnaire was used to interview patients on ART at selected health facilities. Bivariate and multivariate analyses were used to establish the predictors for first line ART failure among ART patients.
Findings: A total 150 cases, 150 controls were recruited; females were majority with 58% and 53% in both arms. Multivariate analysis generated 3 risk factors-poor adherence(AOR=3.17,95%CI:1.42-7.09),baseline WHO stage 3 or 4(AOR=1.85,95%CI:1.03-3.30) and TB infection while on ART (AOR=2.68, 95%CI:1.51-4.76) , 2 protective factors-being a member of an HIV/AIDS support group(AOR=0.27,95%CI:0.15-0.48) and condom use(AOR=0.41,95%CI:0.23-0.71).
Conclusions: The findings of this study confirm that First line ART failure was related to poor adherence to ART, TB infection while on ART, baseline WHO stage 3 or 4 which were key factors for first ART failure in Gutu district.HIV response interventions should focus on adherence counseling and institute education and awareness programmes for early treatment seeking behavior.
Key words: First line ART failure, risk factors, protective factors, independent factors.