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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
immunology and microbiology
Early loss to follow-up of recently diagnosed HIV-infected adults from routine pre-ART care in a rural district hospital in Kenya: a cohort study
Tropical Medicine and International Health, Volume 17, No. 1, Year 2012
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Description
Objective To determine the rate and predictors of early loss to follow-up (LTFU) for recently diagnosed HIV-infected, antiretroviral therapy (ART)-ineligible adults in rural Kenya. Methods Prospective cohort study. Clients registering for HIV care between July 2008 and August 2009 were followed up for 6months. Baseline data were used to assess predictors of pre-ART LTFU (not returning for care within 2months of a scheduled appointment), LTFU before the second visit and LTFU after the second visit. Logistic regression was used to determine factors associated with LTFU before the second visit, while Cox regression was used to assess predictors of time to LTFU and LTFU after the second visit. Results Of 530 eligible clients, 178 (33.6%) were LTFU from pre-ART care (11.1/100 person-months). Of these, 96 (53.9%) were LTFU before the second visit. Distance (>5km vs. <1km: adjusted hazard ratio 2.6 [1.9-3.7], P<0.01) and marital status (married vs. single: 0.5 [0.3-0.6], P<0.01) independently predicted pre-ART LTFU. Distance and marital status were independently associated with LTFU before the second visit, while distance, education status and seasonality showed weak evidence of predicting LTFU after the second visit. HIV disease severity did not predict pre-ART LTFU. Conclusions A third of recently diagnosed HIV-infected, ART-ineligible clients were LTFU within 6months of registration. Predictors of LTFU among ART-ineligible clients are different from those among clients on ART. These findings warrant consideration of an enhanced pre-ART care package aimed at improving retention and timely ART initiation. © 2011 Blackwell Publishing Ltd.
Authors & Co-Authors
Hassan, Amin Shaban
Unknown Affiliation
Fielding, Katherine Linda
Unknown Affiliation
Thuo, Nahashon M.
Unknown Affiliation
Nabwera, Helen M.
Unknown Affiliation
Sanders, Eduard Joachim
Unknown Affiliation
Berkley, James A.
Unknown Affiliation
Statistics
Citations: 50
Authors: 6
Affiliations: 4
Identifiers
Doi:
10.1111/j.1365-3156.2011.02889.x
ISSN:
13602276
e-ISSN:
13653156
Research Areas
Environmental
Health System And Policy
Infectious Diseases
Study Design
Cohort Study
Study Approach
Quantitative
Study Locations
Kenya