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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Retention in a NGO supported antiretroviral program in the Democratic Republic of Congo
PLoS ONE, Volume 7, No. 7, Article e40971, Year 2012
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Description
Background: Retention of patients in ART care is a major challenge in sub-Saharan programs. Retention is also one of the key indicators to evaluate the success of ART programs. Methods and Findings: A retrospective review of 1500 randomly selected medical charts of adult ART patients from a local non-governmental (NGO) supported ART program in the Democratic Republic of Congo (DRC). Retention was defined as any visit to the clinic in the 4 months prior to the abstraction date. Retention over time and across different sites was described. The relationship between patient characteristics and retention rates at 1 year was also examined. 1450 patients were included in the analysis. The overall retention rates were 81.4% (95% CI: 79.3-83.4), 75.2% (95% CI: 72.8-77.3), 65.0% (95% CI: 62.3-67.6) and 57.2% (95% CI: 54.0-60.3) at 6 months, 1 year, 2 years and 3 years respectively. The retention rates between sites varied between 62.1% and 90.6% at 6 months and between 55.5% and 86.2% at 1 year. During multivariable analysis weight below 50 kg (aHR: 1.33, 95%CI: 1.05-1.69), higher WHO stage at initiation (aHR: 1.22, 95%CI 0.85-1.76 for stage 3 and aHR: 2.98, 95%CI: 1.93-4.59 for stage 4), and male sex (aHR: 1.32, 95%CI: 1.05-1.65) remained as significant risk factors for attrition during the first year after ART initiation. Other independent risk factors were year of initiation (aHR: 1.73, 95%CI: 1.26-2.38 for the year 2007 and aHR: 3.06, 95%CI: 2.26-4.14 for the period 2008-2009), and site. Conclusions: Retention is a major problem in DRC, while coverage of patients on ART is still very low. With the flattening of funding for HIV care and treatment in sub-Saharan Africa, and with decreasing funding worldwide, maximizing retention during the much needed scaling-up will even be more important. © 2012 Koole et al.
Authors & Co-Authors
Koole, Olivier
Belgium, Antwerpen
Prins Leopold Instituut Voor Tropische Geneeskunde
Kalenga, Lucien
Congo
School of Public Health
Kiumbu, Modeste
Congo
School of Public Health
Menten, Joris
Belgium, Antwerpen
Prins Leopold Instituut Voor Tropische Geneeskunde
Ryder, Robert W.
United States, La Jolla
University of California, San Diego
Mukumbi, Henry
Congo
School of Public Health
Colebunders, Robert Leon
Belgium, Antwerpen
Prins Leopold Instituut Voor Tropische Geneeskunde
Belgium, Antwerpen
Universiteit Antwerpen
Statistics
Citations: 27
Authors: 7
Affiliations: 4
Identifiers
Doi:
10.1371/journal.pone.0040971
e-ISSN:
19326203
Research Areas
Health System And Policy
Infectious Diseases
Study Design
Cohort Study
Study Locations
Congo
Participants Gender
Male