Skip to content
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Menu
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Menu
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
immunology and microbiology
Tracking a sample of patients lost to follow-up has a major impact on understanding determinants of survival in HIV-infected patients on antiretroviral therapy in Africa
Tropical Medicine and International Health, Volume 15, No. SUPPL. 1, Year 2010
Notification
URL copied to clipboard!
Description
Objective To date, data regarding the determinants of mortality in HIV-infected patients starting antiretroviral therapy (ART) in Africa have been primarily derived from routine clinical care settings practicing the public health approach. Losses to follow-up, however, are high in these settings and may lead to bias in understanding the determinants of mortality. Methods We evaluated HIV-infected adults initiating ART between January 1, 2004 and September 30th, 2007 in an ART clinic in southwestern Uganda. Clinical and demographic characteristics were obtained through routine clinical care. In evaluating determinants of mortality, a 'naïve' analysis used only deaths known through routine processes. A 'sample-corrected' approach incorporated, through probability weights, outcomes from a representative sample of patients lost to follow-up whose vital status was ascertained through tracking in the community. Results In 3,628 patients followed for up to 3.75 years after ART initiation, the 'naïve' approach identified male sex and lower pre-ART CD4 count as independent determinants of mortality. The 'sample-corrected' approach found lower pre-ART CD4 count, older age, lower weight and calendar year of ART initiation, but not male sex, to be independent determinants of mortality. Conclusions Analyses to identify determinants of mortality in HIV-infected patients on ART in Africa that do not account for losses to follow-up can identify spurious associations and miss actual relationships - both with the potential to mislead public health efforts. A sampling-based approach to account for losses to follow-up represents a feasible and potentially scalable method to strengthen the evidence available for implementation of ART delivery in Africa. © 2010 Blackwell Publishing Ltd.
Authors & Co-Authors
Geng, Elvin H.
United States, San Francisco
University of California, San Francisco
Glidden, David V.
United States, San Francisco
University of California, San Francisco
Emenyonu, Nneka I.
United States, San Francisco
University of California, San Francisco
Uganda, Mbarara
Mbarara University of Science and Technology
Musinguzi, Nicholas
United States, San Francisco
University of California, San Francisco
Uganda, Mbarara
Mbarara University of Science and Technology
Bwana, Mwebesa Bosco
United States, San Francisco
University of California, San Francisco
Uganda, Mbarara
Mbarara University of Science and Technology
Neilands, Torsten B.
United States, San Francisco
University of California, San Francisco
United States, San Francisco
Ucsf Center for Aids Prevention Studies
Muyindike, Winnie R.
United States, San Francisco
University of California, San Francisco
Uganda, Mbarara
Mbarara University of Science and Technology
Yiannoutsos, Constantin Theodore
United States, San Francisco
University of California, San Francisco
United States, Indianapolis
Indiana University-purdue University Indianapolis
Deeks, Steven G.
United States, San Francisco
University of California, San Francisco
Bangsberg, David R.
United States, San Francisco
University of California, San Francisco
Uganda, Mbarara
Mbarara University of Science and Technology
United States, Boston
Harvard Medical School
Martin, Jeffrey N.
United States, San Francisco
University of California, San Francisco
Statistics
Citations: 91
Authors: 11
Affiliations: 5
Identifiers
Doi:
10.1111/j.1365-3156.2010.02507.x
ISSN:
13602276
e-ISSN:
13653156
Research Areas
Health System And Policy
Infectious Diseases
Study Design
Cohort Study
Study Locations
Uganda
Participants Gender
Male