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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Medication possession ratio: Predicting and decreasing loss to follow-up in antiretroviral treatment programs in Côte d'Ivoire
Journal of Acquired Immune Deficiency Syndromes, Volume 57, No. SUPPL. 1, Year 2011
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Description
Background: In antiretroviral therapy (ART) programs, decreasing loss to follow up (LTFU) is a major priority. Methods We conducted a prospective study in Abidjan. Adults who started ART between June 2005 and May 2008 and were still in care 6 months later had monthly visits, biannual CD4 counts, computerized data collection and home visits (routine follow-up). A subset of patients also had biannual plasma HIV-1 RNA measurements, with a physician and a research assistant hired to pay particular attention to their visits (enhanced follow-up). We analyzed the association between 18-month outcomes and pre-ART characteristics, medication possession ratio (MPR) and type of follow-up. Patients were LTFU if their last visit was before month-18 and they had not returned to care by month-24. Results: 2,074 patients started ART, of whom 1,636 (79%) were still in care at month-6. The routine (n = 999) and enhanced (n = 637) groups had similar baseline characteristics. From month-6 to month-18, they had similar death rates (routine 3.6%, enhanced 3.9%, P = 0.74), but the enhanced group had significantly less LTFU (routine 11.3%, enhanced 5.8%, P < 0.001). In multivariate analysis, the risk of LTFU from month-6 to month-18 was 46% lower with enhanced follow-up, 56% higher in patients living outside the centre area, and 4.0 fold higher in patients with a low MPR (<80%) between ART initiation and month-6. Conclusions: In patients still in care at 6 months, a low MPR in the first 6 months was strongly associated with further LTFU. Simple follow-up enhancement halved the LTFU rate in the following year. Copyright © 2011 by Lippincott Williams & Wilkins.
Authors & Co-Authors
Messou, Eugéne
Cote D'ivoire, Abidjan
Programme Pacci-cirba
Cote D'ivoire, Abidjan
Aconda
United States, Boston
Massachusetts General Hospital
Kouakou, Martial Guillaume
Cote D'ivoire, Abidjan
Aconda
Gabillard, Delphine
Cote D'ivoire, Abidjan
Programme Pacci-cirba
France, Paris
Inserm
Gouessé, Patrice
Cote D'ivoire, Abidjan
Aconda
Koné, Mamadou
Cote D'ivoire, Abidjan
Aconda
Tchehy, Amah
Cote D'ivoire, Abidjan
Aconda
Losina, Elena
United States, Boston
Massachusetts General Hospital
Freedberg, Kenneth A.
United States, Boston
Massachusetts General Hospital
Dri-Yoman, Thérèse N.
Cote D'ivoire, Abidjan
Programme Pacci-cirba
Cote D'ivoire, Abidjan
Aconda
Anzian, Amani
Cote D'ivoire, Abidjan
Programme Pacci-cirba
Cote D'ivoire, Abidjan
Aconda
Touré, Siaka
Cote D'ivoire, Abidjan
Programme Pacci-cirba
Cote D'ivoire, Abidjan
Aconda
Anglaret, Xavier
Cote D'ivoire, Abidjan
Programme Pacci-cirba
France, Paris
Inserm
Statistics
Citations: 12
Authors: 12
Affiliations: 4
Identifiers
Doi:
10.1097/QAI.0b013e3182208003
ISSN:
15254135
Research Areas
Infectious Diseases
Study Design
Cohort Study
Grounded Theory
Study Locations
Ivory Coast