Patient retention in antiretroviral therapy programs up to three years on treatment in sub-Saharan Africa, 2007–2009: systematic review
TLDR
In this article, the proportion of all-cause adult patient attrition from antiretroviral therapy (ART) programs in service delivery settings in sub-Saharan Africa through 36 months on treatment was estimated.Abstract:
Summary objectives To estimate the proportion of all-cause adult patient attrition from antiretroviral therapy (ART) programs in service delivery settings in sub-Saharan Africa through 36 months on treatment. methods We identified cohorts within Ovid Medline, ISI Web of Knowledge, Cochrane Database of Systematic Reviews and four conference abstract archives. We summarized retention rates from studies describing observational cohorts from sub-Saharan Africa reporting on adult HIV 1- infected patients initiating first-line three-drug ART. We estimated all-cause attrition rates for 6, 12, 18, 24, or 36 months after ART initiation including patients who died or were lost to follow-up (as defined by the author), but excluding transferred patients. results We analysed 33 sources describing 39 cohorts and 226 307 patients. Patients were more likely to be female (median 65%) and had a median age at initiation of 37 (range 34‐40). Median starting CD4 count was 109 cells ⁄mm 3 . Loss to follow-up was the most common cause of attrition (59%), followed by death (41%). Median attrition at 12, 24 and 36 months was 22.6% (range 7%‐45%), 25% (range 11%‐32%) and 29.5% (range 13%‐36.1%) respectively. After pooling data in a random-effects metaanalysis, retention declined from 86.1% at 6 months to 80.2% at 12 months, 76.8% at 24 months and 72.3% at 36 months. Adjusting for variable follow-up time in a sensitivity analysis, 24 month retention was 70.0% (range: 66.7%‐73.3%), while 36 month retention was 64.6% (range: 57.5%‐72.1%). conclusions Our findings document the difficulties in retaining patients in care for lifelong treatment, and the progress being made in raising overall retention rates.read more
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Retention in HIV Care between Testing and Treatment in Sub-Saharan Africa: A Systematic Review
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References
More filters
Journal ArticleDOI
Transformations Related to the Angular and the Square Root
Murray F. Freeman,John W. Tukey +1 more
TL;DR: In this paper, an empirical study of a number of approximations for variance stabilization is presented, some intended for significance and confidence work and others for variance stabilisation for Poisson data.
Journal ArticleDOI
Prognosis of HIV-1-infected patients starting highly active antiretroviral therapy: a collaborative analysis of prospective studies.
Matthias Egger,Margaret T May,Geneviève Chêne,Andrew N. Phillips,Bruno Ledergerber,François Dabis,Dominique Costagliola,Antonella d'Arminio Monforte,Frank de Wolf,Peter Reiss,Jens D Lundgren,Amy C. Justice,Schlomo Staszewski,Catherine Leport,Robert S. Hogg,Caroline A. Sabin,M. John Gill,Bernd Salzberger,Jonathan A C Sterne +18 more
TL;DR: The CD4 cell count at initiation was the dominant prognostic factor in patients starting HAART, and should be taken into account in future treatment guidelines.
BookDOI
Systematic Reviews in Health Care
TL;DR: An output voltage wave having a desired amplitude and frequency is formed from selected portions of the AC signal generated by an induction generator, without affecting the phase angle of the output current, which is determined by the load.
Journal ArticleDOI
Patient Retention in Antiretroviral Therapy Programs in Sub-Saharan Africa: A Systematic Review
TL;DR: Better patient tracing procedures, better understanding of loss to follow-up, and earlier initiation of ART to reduce mortality are needed if retention in ART programs in sub-Saharan Africa is to be improved.
Journal ArticleDOI
Early mortality among adults accessing antiretroviral treatment programmes in sub-Saharan Africa.
TL;DR: Strategies to reduce mortality must include earlier diagnosis of HIV infection, strengthening of longitudinal HIV care and timely initiation of antiretroviral treatment, especially in patients who present with advanced immunodeficiency.
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