Eearly loss of HIV-infected patients on potent antiretroviral therapy programmes in lower-income countries

Adult Male Asia Adolescent International Cooperation Antiretroviral Therapy 610 HIV Infections Health Services Accessibility 03 medical and health sciences 0302 clinical medicine Risk Factors Antiretroviral Therapy, Highly Active 616 Humans Highly Active Developing Countries Primary Care Proportional Hazards Models Public Health Informatics *HIV-1 South America Continuity of Patient Care Middle Aged Patient Acceptance of Health Care CD4 Lymphocyte Count 3. Good health Logistic Models [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie Africa HIV-1 [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie Female Health Services Research *Developing Countries Public aspects of medicine RA1-1270 Program Evaluation
DOI: 10.2471/blt.07.044248 Publication Date: 2008-09-01T12:29:04Z
ABSTRACT
Objective To analyse the early loss of patients to antiretroviral therapy (ART) programmes in resource-limited settings.Methods Using data on 5491 adult starting ART (median age 35 years, 46% female) 15 treatment Africa, Asia and South America with ³ 12 months follow-up, we investigated risk factors for no follow-up after initiation, or death first 6 months.Findings Overall, 211 (3.8%) had 880 (16.0%) were lost 141 (2.6%) known have died months.The probability was higher 2003-2004 than 2000 earlier (odds ratio, OR: 5.06; 95% confidence interval, CI: 1.28-20.0),as (hazard HR: 7.62; 4.55-12.8)but not recorded (HR: 1.02; 0.44-2.36).Compared a baseline CD4-cell count 50 cells/µl, < 25 cells/µl associated (OR: 2.49; 1.43-4.33),loss 1.48; 1.23-1.77)and 3.34; 2.10-5.30).Compared free treatment, fee-for-service 3.71; 0.97-16.05)and mortality 4.64; 1.11-19.41).Conclusion Early patient losses increasingly common when scaled up fee service advanced immunodeficiency at baseline.Measures maximize programme retention are required resource-poor countries.
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