Abstract

Background: In December 2016, the Cameroon Ministry of Public health in partnership with WHO updated its HIV guidelines to a Test and Treat All Strategy, expanding Antiretroviral Therapy eligibility to all individuals with HIV infection, regardless of CD4+ cell count. Understanding trends in HIV treatment outcomes is a key to improving the effectiveness of HIV care and treatment programs. Hence this study was thus prompted to determine the Trends in HIV treatment outcomes among adult patients in the context of universal test and treat at the Nylon Health district, Douala.

Methods: A four years retrospective chart review was conducted between January 2022 and October 2022 at the Nylon Health District, Douala. Of the 707 files reviewed, 429 files of adults who initiated ART between 1st January 2017 and 31st December 2017 in the Nylon health District were included and 278 files were excluded based on the exclusion criteria (transferred out files (74), transferred in files (139), Files of patients who died (30) and missing patient’s files (35)). Ethical clearance was gotten from the Institutional Ethical Review board of the Faculty of Health Sciences University of Buea. Data were abstracted using data extraction forms. Descriptive statistics, Multinomial logistic regression were done using SPSS version 25 and reported as adjusted odd ratios at 95% confidence interval. A variable with a p-value <0.05 was considered to be statistically significant.

Results: A decreasing trend in adherence rate was observed over four years with a mean adherence rate of 62.7%. Retention rates decreased with time with a mean retention rate of 56.6% and viral load suppression rate of 96.4%. Participants who were employed were 3 times significantly more likely to be adherent compared to those who were unemployed (aOR 2.41, 95% CI: 1.24-4.67, p=0.009). Participants with CD4 cell counts at initiation <200 cells/mm3 were about 2 times significantly more likely to be retained in care compared to those who did not have CD4 cell counts results at (aOR 2.78, 95% CI: 1.21-6.38, p=0.016).. Similarly, clients who were enrolled into care at WHO clinical stage II were 3 times more likely to be retained in care compared to the clients who started ART at disease stage IV (aOR 3.28, 95% CI: 1.02-10.54, p=0.046).

Conclusion:  The Adherence rate and retention rates were low. The rate of viral load was high .Again employment status showed a significant association with adherence. CD4 cell count at initiation and WHO clinical stage showed a significant association with retention in care. A significant association was found between viral load suppression and ART adherence, and viral load suppression and retention in care.

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