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Abstract：
BACKGROUND: Ethiopia\'s viral suppression rate was less than 90% by 2020, and more than 10% of adult clients on ART in Woliso Town were unsuppressed at the end of March 2022. This study aims to identify determinants of virologic failure among adult clients on ART at health facilities in Oromia region of Ethiopia.
METHODS: A facility-based unmatched case-control study was conducted at health facilities in Oromia region from August 1 to September 1, 2022. The study cases were clients with virologic-confirmed first-line ART failure, while controls were clients on first-line ART with a suppressed viral load. A total of 135 cases and 268 control participants were selected using simple random sampling techniques, and data were collected by reviewing the client\'s document. Epi-Info7 was used for data entry and SPSS version 20 for data analysis. Variables having a P-value of less than 0.25 in the bi-variable analysis were included in multivariable logistic regression. Determinants of virologic failure were determined based on an adjusted odds ratio using 95% CI and a P-value of < 0.05.
RESULTS: In this study, clients with an age ≥ 35 years (AOR = 3.4, 95% CI: 1.6, 7.0), clients with a baseline regimen of AZT + 3TC + NVP (AOR = 3.5, 95% CI: 1.4, 8.8), clients with a base-line CD4 count < 350 mm3 (AOR = 2.3, 95% CI: 1.1, 4.5), being single marital status (AOR = 3.7, 95% CI: 1.4, 10.5), TB-HIV coinfection (AOR = 2.58, 95% CI: 1.3, 5.1), and having opportunistic infection other than TB in the last six months (AOR = 3.06, 95% CI: 1.5, 6.3) were factors significantly associated with virologic failure while clients within the appointment spacing model (AOR = 0.05, 95% CI: 0.03, 0.10) is inversely associated with virologic failure.
CONCLUSIONS: This study showed that age ≥ 35 years, being single, baseline ART regimen with (AZT + 3TC + NVP), baseline CD4 cell count < 350 mm3, Tb-co infection, and opportunistic infection in the last 6 months were factors associated with virologic failure. Involvement in the appointment spacing model was found to be protective.
METHODS: A facility-based unmatched case-control study was conducted at health facilities in Oromia region from August 1 to September 1, 2022. The study cases were clients with virologic-confirmed first-line ART failure, while controls were clients on first-line ART with a suppressed viral load. A total of 135 cases and 268 control participants were selected using simple random sampling techniques, and data were collected by reviewing the client\'s document. Epi-Info7 was used for data entry and SPSS version 20 for data analysis. Variables having a P-value of less than 0.25 in the bi-variable analysis were included in multivariable logistic regression. Determinants of virologic failure were determined based on an adjusted odds ratio using 95% CI and a P-value of < 0.05.
RESULTS: In this study, clients with an age ≥ 35 years (AOR = 3.4, 95% CI: 1.6, 7.0), clients with a baseline regimen of AZT + 3TC + NVP (AOR = 3.5, 95% CI: 1.4, 8.8), clients with a base-line CD4 count < 350 mm3 (AOR = 2.3, 95% CI: 1.1, 4.5), being single marital status (AOR = 3.7, 95% CI: 1.4, 10.5), TB-HIV coinfection (AOR = 2.58, 95% CI: 1.3, 5.1), and having opportunistic infection other than TB in the last six months (AOR = 3.06, 95% CI: 1.5, 6.3) were factors significantly associated with virologic failure while clients within the appointment spacing model (AOR = 0.05, 95% CI: 0.03, 0.10) is inversely associated with virologic failure.
CONCLUSIONS: This study showed that age ≥ 35 years, being single, baseline ART regimen with (AZT + 3TC + NVP), baseline CD4 cell count < 350 mm3, Tb-co infection, and opportunistic infection in the last 6 months were factors associated with virologic failure. Involvement in the appointment spacing model was found to be protective.
摘要：
背景：到2020年，埃塞俄比亚的病毒抑制率不到90％，到2022年3月底，超过10％的Woliso镇接受ART的成年客户未受到抑制。这项研究旨在确定埃塞俄比亚奥罗米亚地区医疗机构接受ART治疗的成年患者病毒学失败的决定因素。
方法：于2022年8月1日至9月1日在奥罗米亚地区的医疗机构进行了一项基于设施的无匹配病例对照研究。研究案例是病毒学证实的一线ART失败的客户，而对照组是病毒载量受抑制的一线ART的客户。使用简单随机抽样技术，共选择135例和268例对照参与者，和数据是通过审查客户的文件收集的。Epi-Info7用于数据输入，SPSS版本20用于数据分析。双变量分析中P值小于0.25的变量包括在多变量逻辑回归中。病毒学失败的决定因素是基于使用95%CI和P值<0.05的调整比值比确定的。
结果：在这项研究中，年龄≥35岁的客户（AOR=3.4，95%CI：1.6，7.0），基线方案为AZT+3TC+NVP的客户(AOR=3.5，95%CI：1.4，8.8)，基线CD4计数<350mm3的客户(AOR=2.3，95%CI：1.1，4.5)，单身婚姻状况(AOR=3.7，95%CI：1.4，10.5)，TB-HIV合并感染（AOR=2.58，95%CI：1.3，5.1），以及在过去6个月内有结核以外的机会性感染(AOR=3.06,95%CI:1.5,6.3)是与病毒学失败显著相关的因素,而预约间隔模型内的客户(AOR=0.05,95%CI:0.03,0.10)与病毒学失败呈负相关.
结论：这项研究表明，年龄≥35岁，单身,基线ART方案（AZT+3TC+NVP），基线CD4细胞计数<350mm3，Tb-co感染，和最近6个月的机会性感染是与病毒学失败相关的因素.参与约会间隔模式被认为是保护性的。
方法：于2022年8月1日至9月1日在奥罗米亚地区的医疗机构进行了一项基于设施的无匹配病例对照研究。研究案例是病毒学证实的一线ART失败的客户，而对照组是病毒载量受抑制的一线ART的客户。使用简单随机抽样技术，共选择135例和268例对照参与者，和数据是通过审查客户的文件收集的。Epi-Info7用于数据输入，SPSS版本20用于数据分析。双变量分析中P值小于0.25的变量包括在多变量逻辑回归中。病毒学失败的决定因素是基于使用95%CI和P值<0.05的调整比值比确定的。
结果：在这项研究中，年龄≥35岁的客户（AOR=3.4，95%CI：1.6，7.0），基线方案为AZT+3TC+NVP的客户(AOR=3.5，95%CI：1.4，8.8)，基线CD4计数<350mm3的客户(AOR=2.3，95%CI：1.1，4.5)，单身婚姻状况(AOR=3.7，95%CI：1.4，10.5)，TB-HIV合并感染（AOR=2.58，95%CI：1.3，5.1），以及在过去6个月内有结核以外的机会性感染(AOR=3.06,95%CI:1.5,6.3)是与病毒学失败显著相关的因素,而预约间隔模型内的客户(AOR=0.05,95%CI:0.03,0.10)与病毒学失败呈负相关.
结论：这项研究表明，年龄≥35岁，单身,基线ART方案（AZT+3TC+NVP），基线CD4细胞计数<350mm3，Tb-co感染，和最近6个月的机会性感染是与病毒学失败相关的因素.参与约会间隔模式被认为是保护性的。
