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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
immunology and microbiology
Early active follow-up of patients on antiretroviral therapy (ART) who are lost to follow-up: The 'Back-to-Care' project in Lilongwe, Malawi
Tropical Medicine and International Health, Volume 15, No. SUPPL. 1, Year 2010
Notification
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Description
Objectives To determine the proportion of patients returning to antiretroviral treatment (ART) and factors associated with their return in a resource-limited setting. Methods Between September 2006 and March 2009, at two ART-providing facilities in Lilongwe, Malawi, we identified patients who had missed clinic appointments by more than 3 weeks and therefore would have run out of antiretroviral drugs. We traced these individuals, documented reasons for missed appointments and, where appropriate, arranged another ART clinic appointment. Results Between April 2006 and March 2009, 2653 patients on ART had missed 3098 scheduled appointments. We successfully traced 85%, of whom 30% had died. Of the 1580 patients found alive, 25% had transferred to another ART clinic, 21% had collected drugs from other sources, 11% had treatment gaps; 40% had stopped taking drugs, 1% had not started taking drugs despite collecting them and 2% refused to be interviewed. Of the 1158 LTFU patients who had not died, transferred out or declined to be interviewed, 89% promised to return to their ART clinic and 74% actually did. The probability of returning to the clinic was significantly associated with being women, aged over 39 at ART initiation and having either treatment gaps or uninterrupted therapy. The B2C project reduced the proportion of patients finally classified as LTFU by 59%. Conclusion Early active follow-up of LTFU patients resulted in marked improvement in known patient outcomes and improved retention in the treatment programme. © 2010 Blackwell Publishing Ltd.
Authors & Co-Authors
Tweya, Hannock M.
France, Paris
International Union Against Tuberculosis and Lung Disease
Malawi, Lilongwe
Lighthouse Trust
Gareta, Dickman
Malawi, Lilongwe
Lighthouse Trust
Chagwera, Frederick
Malawi, Lilongwe
Lighthouse Trust
Ben-Smith, Anne W.
Unknown Affiliation
Mwenyemasi, Justin
Malawi, Lilongwe
Lighthouse Trust
Chiputula, Fred
Malawi, Lilongwe
Lighthouse Trust
Boxshall, Matt
Malawi, Lilongwe
Lighthouse Trust
Weigel, Ralf
Malawi, Lilongwe
Lighthouse Trust
Malawi, Lilongwe
Ministry of Health Malawai
Jahn, Andreas
Malawi, Lilongwe
Ministry of Health Malawai
Malawi, Seattle
I-tech Lilongwe
Hosseinipour, Mina C.
Malawi, Lilongwe
University of North Carolina
Phiri, Sam John Peter
Malawi, Lilongwe
Lighthouse Trust
Statistics
Citations: 103
Authors: 11
Affiliations: 5
Identifiers
Doi:
10.1111/j.1365-3156.2010.02509.x
ISSN:
13602276
e-ISSN:
13653156
Research Areas
Health System And Policy
Study Design
Cohort Study
Study Locations
Malawi
Participants Gender
Female