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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Outcomes and associated risk factors of patients traced after being lost to follow-up from antiretroviral treatment in Lilongwe, Malawi
BMC Infectious Diseases, Volume 11, Article 31, Year 2011
Notification
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Description
Background: Loss to follow-up is a major challenge of antiretroviral treatment (ART) programs in sub-Saharan Africa. Our objective was to a) determine true outcomes of patients lost to follow-up (LTFU) and b) identify risk factors associated with successful tracing and deaths of patients LTFU from ART in a large public sector clinic in Lilongwe, Malawi.Methods: Patients who were more than 2 weeks late according to their last ART supply and who provided a phone number or address in Lilongwe were eligible for tracing. Their outcomes were updated and risk factors for successful tracing and death were examined.Results: Of 1800 patients LTFU with consent for tracing, 724 (40%) were eligible and tracing was successful in 534 (74%): 285 (53%) were found to be alive and on ART; 32 (6%) had stopped ART; and 217 (41%) had died. Having a phone contact doubled tracing success (adjusted odds ratio, aOR = 2.1, 95% CI 1.4-3.0) and odds of identifying deaths [aOR = 1.8 (1.2-2.7)] in patients successfully traced. Mortality was higher when ART was fee-based at initiation (aOR = 2.3, 95% CI 1.1-4.7) and declined with follow-up time on ART. Limiting the analysis to patients living in Lilongwe did not change the main findings.Conclusion: Ascertainment of contact information is a prerequisite for tracing, which can reveal outcomes of a large proportion of patients LTFU. Having a phone contact number is critical for successful tracing, but further research should focus on understanding whether phone tracing is associated with any differential reporting of mortality or LTFU. © 2011 Weigel et al; licensee BioMed Central Ltd.
Available Materials
https://efashare.b-cdn.net/share/pmc/articles/PMC3039578/bin/1471-2334-11-31-S1.DOC
Authors & Co-Authors
Weigel, Ralf
Malawi, Lilongwe
Kamuzu Central Hospital
Switzerland, Nottwil
Swiss Paraplegic Centre
Hochgesang, Mindy
United States, Atlanta
Centers for Disease Control and Prevention
Brinkhof, Martin W.G.
Switzerland, Bern
University of Bern
Hosseinipour, Mina C.
Malawi, Lilongwe
Unc Project-malawi
Boxshall, Matt
Malawi, Lilongwe
Kamuzu Central Hospital
Mhango, Eustice
Malawi, Lilongwe
Ministry of Health Malawai
Nkwazi, Brains
Malawi, Lilongwe
Kamuzu Central Hospital
Tweya, Hannock M.
Malawi, Lilongwe
Kamuzu Central Hospital
Kamlaka, Maggie
Malawi, Lilongwe
Kamuzu Central Hospital
Chagwera, Frederick
Malawi, Lilongwe
Kamuzu Central Hospital
Phiri, Sam John Peter
Malawi, Lilongwe
Kamuzu Central Hospital
Statistics
Citations: 67
Authors: 11
Affiliations: 6
Identifiers
Doi:
10.1186/1471-2334-11-31
e-ISSN:
14712334
Research Areas
Health System And Policy
Study Design
Cohort Study
Case-Control Study
Study Locations
Malawi