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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Lower early mortality rates among patients receiving antiretroviral treatment at clinics offering cotrimoxazole prophylaxis in Malawi
Journal of Acquired Immune Deficiency Syndromes, Volume 46, No. 1, Year 2007
Notification
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Description
OBJECTIVE: To determine whether Malawi antiretroviral treatment (ART) clinics providing cotrimoxazole (CTX) prophylaxis had lower early mortality rates compared with clinics not providing CTX. METHODS: Retrospective cohort study of eleven ART clinics in Malawi that were or were not providing CTX. Medical record abstraction was performed for all patients (N = 1295) initiating ART between July 1 and December 15, 2005. At 5 ART sites, CTX was given to patients dosed at 960 mg daily or 480 mg twice a day (according to national guidelines). RESULTS: When all defaults (patients lost to follow-up for >90 days) were excluded from the analysis, the 6-month mortality rate was 10.7% in patients receiving ART at CTX clinics compared with 18.0% in those not at CTX clinics (6-month mortality risk reduction = 40.7%; P = 0.0013). Kaplan-Meier survival curves for patients receiving CTX and patients not receiving CTX were significantly different; survival differences were apparent as early as 40 to 45 days after initiation of ART. CONCLUSIONS: Patients receiving ART in Malawi at clinics offering CTX prophylaxis had significantly reduced mortality during the first 6 months of ART. This additional intervention may have the potential to improve the lives of patients on ART, because CTX is readily available and relatively inexpensive and can, in principle, be easily introduced into ART delivery programs. © 2007 Lippincott Williams & Wilkins, Inc.
Authors & Co-Authors
Lowrance, David W.
Unknown Affiliation
Makombe, Simon D.
Unknown Affiliation
Harries, Anthony David
Unknown Affiliation
Yu, Joseph Kwong Leung
Unknown Affiliation
Aberle-Grasse, John M.
Unknown Affiliation
Eiger, Odette
Unknown Affiliation
Shiraishi, Ray W.
Unknown Affiliation
Marston, Barbara J.
Unknown Affiliation
Ellerbrock, Tedd V.
Unknown Affiliation
Libamba, Edwin
Unknown Affiliation
Statistics
Citations: 73
Authors: 10
Affiliations: 6
Identifiers
Doi:
10.1097/QAI.0b013e3181378ed2
ISSN:
15254135
Research Areas
Health System And Policy
Study Design
Randomised Control Trial
Cohort Study
Study Approach
Quantitative
Study Locations
Malawi