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Table 1 Characteristics of studies describing the magnitude and causes of first-line regimen change

From: Magnitude and causes of first-line antiretroviral therapy regimen changes among HIV patients in Ethiopia: a systematic review and meta-analysis

Author (year of publication) Quality Score Study design Study setting (region) Year of study Included Age group (in year) Sample size Number of cases (first line ART regimen change) Number of each causes/reasons reported for regimen change No %
Wube M et al. (2013) [31] 7 Retrospective cross sectional Nekemt hospital, 2010 ≥15 years 142 NA Toxicity/side effect 114 80.3
Pregnancy 9 6.3
TB co morbidity 8 5.6
Drug stock out 7 4.9
Treatment failure 4 2.8
Zeleke A (2016) [27] 6.5 Retrospective cross sectional University of Gondar Hospital 2014 < 15 years 225 101 (44.9%) Side effects 29 12.9
Diagnosis of TB 32 14.2
Program shift from D4T to AZT or TDF 32 14.2
Stock out of drugs 5 2.2
Sisay MS et al., (2018) [28] 7 Retrospective follow up Selected hospitals in Amhara National Regional State 2016 < 15 years 824 299 (36.3%) Drug stock out 145 48.5
Drug side effects/toxicity 72 24.1
Treatment failure 67 22.4
New TB case 8 2.7
Other 7 2.3
Jima Y et al. (2013) [15] 7 Retrospective cross sectional Selected health facilities in Addis Ababa 2010 ≥18 years 300 NA Toxicity 195 65.0
TB Co-morbidity 75 25.0
Pregnancy 15 5.0
Treatment failure 9 3.0
Adherence difficulty 6 2.0
Anlay DZ et al. (2016) [32] 8 Retrospective follow up University of Gondar Hospital 2015 ≥15 years 410 88 (21.5%) Side effects 62 70.45
Tuberculosis 18 20.45
Pregnancy 4 4.5
Virological failure 3 3.4
Occurrence of hepatitis B with chronic liver diseases 1 1.1
Kasu B et al. (2017) [43] 6.5 Retrospective cross sectional Asella referral Hospital 2015 All 1468 221 (15.1%) Drug toxicity 84 38.0
Treatment failure 54 24.4
Poor adherence 51 23.1
Pregnancy 21 9.5
Co-morbidity due to TB 11 4.9
Gebremedhin L et al. (2014) [44] 6 Retrospective cross sectional Ayder Referral Hospital, Mekelle 2013 All 720 157 (21.8%) Toxicity 119 75.8
Tuberculosis 22 14.0
Treatment failure 15 9.6
Pregnancy 1 0.6
Teklay G et al. (2013) [45] 7.5 Retrospective cross sectional Jimma University Specialized Hospital 2012 All 403 257 (62.8%) Weight gain 129 50.2
Toxicity 77 30.0
TB treatment interaction 44 17.1
Pregnancy 8 3.3
Treatment failure 1 0.4
Geremew A et al. (2014) [33] 7.5 Retrospective cross sectional Jimma University Specialized Hospital 2013 ≥ 18 years 324 121 (37.3%) Toxicity/side effect 86 71.1
Treatment failure 25 20.7
Pregnancy 7 5.8
New TB 3 2.5
Mulugeta A et al. (2012) [34] 7 Cross sectional Dessie Regional Referral Hospital 2007 ≥ 18 years 122 NA Toxicity 80 65.6
TB Co-morbidity 17 13.9
Pregnancy 14 11.5
Treatment failure 8 6.6
Adherence difficulty 3 2.4
Woldemedhin B et al. (2012) [46] 6 Retrospective cross sectional Hawasa referral Hospital and shashemene referral Hospital 2010 All 340 NA Toxicity 230 67.6
Co-morbidity with TB 65 19.1
Pregnancy 36 10.6
Treatment failure 9 2.6
Assefa D et al. (2014) [35] 6.5 Retrospective cross sectional Fitche Hospital 2013 ≥ 18 years 68 NA Toxicity 56 72.7
Co-morbidity TB 2 2.6
New drug available 7 9.1
Treatment failure 11 14.2
Patient refused to take the drug 1 1.3
Yirdaw B et al. (2014) [42] 6 Retrospective Felege Hiwot referral hospital 2013 ≥ 15 years 387 189 (49.2%) NA   
Kassie Y et al. (2014) [36] 6 Retrospective cross sectional Bedele Hospital 2013 ≥ 18 years 84 NA Toxicity 63 75.0
Co-morbidity due to TB 10 11.9
Pregnancy 10 11.9
Treatment failure 1 1.2
Haile D, et al. (2016) [37] 7 Retrospective cohort study Selected Hospitals in Bale 2014 ≥ 15 years 4809 1630 (33.9%) NA   
Tadesse W et al. (2014) [38] 7.5 Cross sectional University of Gondar Hospital 2012 ≥ 18 years 384 78 (20.3%) Adverse drug reaction 62 79.5
Treatment failure 10 12.8
Tuberculosis co-morbidity 4 5.1
Pregnancy 2 2.6
Bilie B et al. (2017) [39] 7.5 Retrospective Jimma University Specialized Hospital 2013 ≥ 18 years 1284 615 (47.9%) Toxicity 301 48.9
TB Comorbidity 88 14.3
Phaseout 124 20.2
Pregnancy 24 3.9
Treatment failure 4 0.6
Drug out of stock 3 0.5
Hepatitis 1 0.2
Unknown 70 11.4
Tadesse B et al. (2017) [29] 8 Prospective cohort Selected hospitals in Southern Nations Nationalities and Peoples Region 2016 <  18 years 628 253 (42.6%) Toxicity or side effects 39 14.7
TB co-infection 2 0.8
National Guideline Change 187 70.3
Yassin S et al. (2017) [30] 7 Retrospective cohort Fiche and Kuyuhospitals 2015 < 15 years 269 131 (48.7%) NA   
Bokore A, et al. (2018) [40] 7 Retrospective cross sectional East and west Wollega health institutions 2017 ≥ 18 years 243 NA Peripheral neuropathy 146 60.1
Hepatotoxicity 22 9.1
d4t faith out 18 7.4
CNS toxicity 16 6.6
Anemia 16 6.6
Rash 15 5.3
Others 10 4.9
Mekonnen E et al. (2018) [41] 7.5 Retrospective cohort Jimma University Tertiary Hospital 2014 ≥ 18 years 1533 731 (47.7%) Drug toxicities 431 58.9
A new TB treatment 120 16.4
Pregnancy 29 3.9
Treatment failure 24 3.3
Others 127 17.4
  1. Abbreviations: NA Not applicable, TB Tuberculosis, CNS Central Nervous System, AZT Zidovudine, TDF Tenofovir, d4T Stavudine