{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T20:15:54Z","timestamp":1790885754996,"version":"4.1.0"},"reference-count":20,"publisher":"Public Library of Science (PLoS)","issue":"10","license":[{"start":{"date-parts":[[2022,10,13]],"date-time":"2022-10-13T00:00:00Z","timestamp":1665619200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Lost to follow-up (LTFUP) continues to threaten the sustainability of antiretroviral therapy (ART) benefits and success of ART programs. We determined the incidence and predictors of LTFUP among people living with HIV (PLHIV) on ART in Nyarugenge the Central Business District of Kigali city.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>A cohort of PLHIV who initiated ART in 2018 was retrospectively studied for 24 months. Using health facility records, a person who had no record of contact with the health facility for at least three consecutive months was considered LTFUP. LTFUP incidence rates were computed, and the Fine-Gray\u2019s competing risk regression models were used to determine factors associated with time to first LTFUP. Generalized estimating equations (GEEs) were used to analyze repeated measurement outcomes of LTFUP and predictors of LTFUP.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Of 950 participants, 581 (61.2%) were females and 866 (91.2%) were 15 to 49 years old. From 1,586.1 person years of observation (pyo), 148 participants got LTFUP for 451 times. The incidence rate to first event was 9.4 per 100 pyo (95%CI:7.9\u201310.9) and 31.8 per 100 pyo (95%CI:29.0\u201334.4) to multiple events. WHO stage, marital status, employment status and person to contact when PLHIV is not reachable were associated with time to first LTFUP event. However, an average participant with a contact person who was not a Community Health Worker (CHW) or a peer educator had higher incidence of LTUP (aIRR = 2.69, 95%CI: 1.43\u20135.06), an average single patients had higher incidence of LTFUP (aIRR = 1.74, 95%CI: 1.28\u20132.34) compared to married\/co-habiting, and an average self-employed had higher incidence of LTFUP (aIRR = 1.51, 95%CI: 1.14\u20132.01) compared to participants employed by others. Furthermore, an average PLHIV living out-of-the health facility catchment area had higher incidence of LTFUP (aIRR = 1.55, 95%CI: 1.19\u20132.01) compared to an average PLHIV living in the health facility catchment area whereas, an average children initiated on first line had lower incidence of LTUP (aIRR = 0.43, 95%CI: 0.21\u20130.86) compared to adults.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Using CHW and peer educators as contact persons can help to reduce LTFUP while, targeted sensitization and service delivery are needed for single, self-employed and, patients living out of the health facility catchment area.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0275954","type":"journal-article","created":{"date-parts":[[2022,10,13]],"date-time":"2022-10-13T17:53:54Z","timestamp":1665683634000},"page":"e0275954","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":10,"title":["Incidence and factors associated with being lost to follow-up among people living with HIV and receiving antiretroviral therapy in Nyarugenge the central business district of Kigali city, Rwanda"],"prefix":"10.1371","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2183-7873","authenticated-orcid":true,"given":"Daniel","family":"Ntabanganyimana","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lawrence","family":"Rugema","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jared","family":"Omolo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivier","family":"Nsekuye","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel Sewava","family":"Malamba","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2022,10,13]]},"reference":[{"key":"pone.0275954.ref001","unstructured":"World Health Organization (WHO). HIV\/AIDS_Fact sheet [Internet], https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/hiv-aids (accessed September 20, 2020)."},{"key":"pone.0275954.ref002","unstructured":"Rwanda Biomedical Center (RBC). Rwanda Population-based HIV Impact Assessment, http:\/\/phia.icap.columbia.edu."},{"key":"pone.0275954.ref003","volume-title":"Policy Brief: Consolidated guidelines on the use of antiretroviral therapy and preventing HIV infection. What\u2019s new","author":"World Health Organization","year":"2015"},{"key":"pone.0275954.ref004","doi-asserted-by":"crossref","unstructured":"World Health Organization (WHO). CONSOLIDATED GUIDELINES ON THE USE OF ANTIRETROVIRAL DRUGS FOR TREATING AND PREVENTING HIV INFECTION. Second edition. 2016. Epub ahead of print 2016. doi: 10.1097\/00022744-199706000-00003","DOI":"10.1097\/00022744-199706000-00003"},{"key":"pone.0275954.ref005","article-title":"Estimating retention in HIV care accounting for patient transfers: A national laboratory cohort study in South Africa","volume":"15","author":"MP Fox","journal-title":"PLoS Medicine"},{"key":"pone.0275954.ref006","article-title":"Estimating loss to follow-up in HIV-infected patients on antiretroviral therapy: The effect of the competing risk of death in Zambia and Switzerland","volume":"6","author":"F Sch\u00f6ni-Affolter","journal-title":"PLoS ONE"},{"key":"pone.0275954.ref007","article-title":"Patient Retention in Antiretroviral Therapy Programs in Sub-Saharan Africa: A Systematic Review","volume":"4","author":"S Rosen","journal-title":"PLoS MEDICINE"},{"key":"pone.0275954.ref008","article-title":"High levels of viral load monitoring and viral suppression under Treat All in Rwanda\u2013a cross\u2010sectional study","author":"J Ross","journal-title":"Journal of the International AIDS Society"},{"key":"pone.0275954.ref009","unstructured":"Rwanda Ministry of health. Health Sector Annual Performance Report, July 2020- June 2021. 2021."},{"key":"pone.0275954.ref010","unstructured":"Rwanda Ministry of health. Rwanda National HIV and Viral Hepatitis Annual Report, 2017\u20132018. 2018."},{"key":"pone.0275954.ref011","doi-asserted-by":"crossref","first-page":"375","DOI":"10.11648\/j.sjph.20160405.12","article-title":"Patient Factors Influencing Adherence to ART Treatment among HIV\/AIDS Patients in Embu Teaching and Referral Hospital Comprehensive Care Clinic","volume":"4","author":"E. Kananu Njue Mugoh","year":"2016","journal-title":"Science Journal of Public Health"},{"key":"pone.0275954.ref012","doi-asserted-by":"crossref","first-page":"453","DOI":"10.4103\/1947-2714.141636","article-title":"Predictors of loss to follow-up in patients living with HIV\/AIDS after initiation of antiretroviral therapy","volume":"6","author":"TM Berheto","year":"2014","journal-title":"North American Journal of Medical Sciences"},{"key":"pone.0275954.ref013","article-title":"Loss to follow-up and associated factors among adult people living with HIV at public health facilities in Wakiso district, Uganda: A retrospective cohort study","volume":"19","author":"D Opio","journal-title":"BMC Health Services Research"},{"key":"pone.0275954.ref014","article-title":"Determinants of loss to follow-up among HIV positive patients receiving antiretroviral therapy in a test and treat setting: A retrospective cohort study in Masaka, Uganda","volume":"15","author":"J Kiwanuka","journal-title":"PLoS ONE"},{"key":"pone.0275954.ref015","article-title":"Incidence and predictors of loss to follow-up among HIV-positive adults in northwest Ethiopia: A retrospective cohort study","volume":"48","author":"MY Birhanu","journal-title":"Tropical Medicine and Health"},{"key":"pone.0275954.ref016","article-title":"Predictors of Loss to Follow Up of Patients Enrolled on Antiretroviral Therapy: A Retrospective Cohort Study","volume":"5","author":"KT Fisaha Haile","journal-title":"Journal of AIDS & Clinical Research"},{"key":"pone.0275954.ref017","article-title":"Factors associated with 36-month loss to follow-up and mortality outcomes among HIV-infected adults on antiretroviral therapy in Central Kenya","volume":"20","author":"P Wekesa","journal-title":"BMC Public Health"},{"key":"pone.0275954.ref018","article-title":"CLINICAL outcomes and loss to follow-up among people living with HIV participating in the NAMWEZA intervention in Dar es Salaam, Tanzania: A prospective cohort study","volume":"14","author":"HN Siril","journal-title":"AIDS Research and Therapy"},{"key":"pone.0275954.ref019","article-title":"Determinants of loss to follow-up in patients on antiretroviral treatment, South Africa, 2004\u20132012: A cohort study","volume":"15","author":"MN Mberi","journal-title":"BMC Health Services Research"},{"key":"pone.0275954.ref020","article-title":"Loss to follow-up and opportunities for reengagement in HIV care in rural Mozambique: A prospective cohort study","volume":"99","author":"L Fuente-Soro","journal-title":"Medicine (United States)"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0275954","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,10,13]],"date-time":"2022-10-13T17:54:06Z","timestamp":1665683646000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0275954"}},"subtitle":[],"editor":[{"given":"Sirinya","family":"Teeraananchai","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2022,10,13]]},"references-count":20,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2022,10,13]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0275954","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,10,13]]}}}