scholarly journals Tracing people living with HIV who are lost to follow-up at ART programs in Southern Africa: Study protocol

2020 ◽  
Author(s):  
Benedikt Christ ◽  
Marie Ballif ◽  
Nanina Anderegg ◽  
Frédérique Chammartin ◽  
Kathrin Zürcher ◽  
...  
Keyword(s):  
Southern Africa ◽  
Monitoring And Evaluation ◽  
People Living With Hiv ◽  
Art Programs ◽  
Standardized Protocol ◽  
Living With Hiv ◽  
Lost To Follow Up ◽  
Biased Estimates ◽  
International Epidemiology

The successful treatment of people living with HIV and the monitoring and evaluation of antiretroviral therapy (ART) programs both depend on regular and complete patient follow-up. Analyses restricted to patients remaining in care will underestimate mortality among all patients who started ART. Biased estimates of program-level mortality hamper the evaluation of single programs and the comparison between programs, settings and countries. We publish here a standardized protocol used to trace patients classified as lost to follow-up at ART programs members of the International Epidemiology Databases to Evaluate AIDS in Southern Africa (IeDEA-SA) and to determine their vital and care status.

scholarly journals Tracing people living with HIV who are lost to follow-up at ART programs in Southern Africa: a multicenter study

2020 ◽  
Author(s):  
Benedikt Christ ◽  
Marie Ballif ◽  
Nanina Anderegg ◽  
Frédérique Chammartin ◽  
Josephine Muhairwe ◽  
...  
Keyword(s):  
Southern Africa ◽  
Home Visits ◽  
Hiv Treatment ◽  
People Living With Hiv ◽  
Art Programs ◽  
Record Keeping ◽  
Phone Calls ◽  
Living With Hiv ◽  
Lost To Follow Up

Introduction: Retention in care is a key element to the HIV treatment cascade and an indicator of the success of ART programs. We traced people living with HIV (PLWH) categorized as lost to follow-up (LTFU) to ascertain whether their vital or care status changed since their last visit. Methods: We used a standardized protocol to trace a stratified sample of PLWH who were LTFU at eight ART programs in South Africa, Zambia, Malawi, Zimbabwe, Lesotho and Mozambique in 2017-2019. Participants were stratified by age, gender, and time on ART. We assessed tracing process outcomes, vital status and care status of participants. Participating ART programs were members of the International epidemiology Databases to Evaluate AIDS (IeDEA) consortium in Southern Africa. Results: We selected a stratified random sample of 3,256 PLWH classified as LTFU; 56% were female, median age was 32 years and 53% were on ART for less than a year. Overall, no tracing was necessary for 12% of the participants, since their vital and care status could be clarified by checking existing participant files before tracing was initiated. Tracing was impossible for another 17%, for whom contact details were unavailable or incomplete. Among the 2,294 PLWH classified as LTFU who were traced by phone calls and/or home visits, 34% were alive and in care, 19% were alive but not in care, and 4% were alive but had unknown care status, while 11% had died, and 32% could not be found. Home visits were more successful than phone calls to ascertain the vital outcome of lost PLWH (OR: 2.7, 95% CI: 1.6–4.4).Conclusions: We showed that tracing allowed ascertaining the vital and care outcomes of PLWH classified as LTFU, but was challenged by insufficient record-keeping. Misclassification of outcomes and incomplete contact information are threatening the efficiency of tracing and ultimately the accuracy of program-level indicators, such as mortality and retention estimates. Our study highlights the need for centralized and standardized patient management systems at HIV clinics in low- and middle-income countries.

scholarly journals Does undernutrition increase the risk of lost to follow-up in adults living with HIV in sub-Saharan Africa? Protocol for a systematic review and meta-analysis

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e048022
Author(s):  
Animut Alebel ◽  
Daniel Demant ◽  
Pammla Petrucka ◽  
David Sibbritt
Keyword(s):  
Systematic Review ◽  
Effect Size ◽  
Grey Literature ◽  
Sub Saharan Africa ◽  
People Living With Hiv ◽  
Significance Level ◽  
Sub Saharan ◽  
Living With Hiv ◽  
Lost To Follow Up

IntroductionUndernutrition is considered a marker for poor prognosis among people living with HIV (PLHIV), particularly in sub-Saharan Africa (SSA), where undernutrition and HIV are both highly prevalent. Evidence suggests that undernutrition (body mass index <18.5 kg/m2) is one of the main factors that significantly increases the risk of lost to follow-up (LTFU) in PLHIV. However, primary studies in SSA have reported inconsistent findings on the relationship between undernutrition and LTFU among adults living with HIV. To the best of our knowledge, no systematic review which aimed to summarise the available evidence. Hence, this review aims to determine the pooled effect of undernutrition on LTFU among adults living with HIV in SSA.Methods and analysisPubMed, EMBASE, Web of Science, Scopus, and, for grey literature, Google Scholar will be systematically searched to include relevant articles published since 2005. Studies reporting the effect of undernutrition on LTFU in adults living with HIV in SSA will be included. The Newcastle-Ottawa Scale will be used for quality assessment. Data from eligible studies will be extracted using a standardised data extraction tool. Heterogeneity between included studies will be assessed using Cochrane Q-test and I2 statistics. The Egger’s and Begg’s tests at a 5% significance level will be used to evaluate publication bias. As heterogeneity is anticipated, the pooled effect size will be estimated using a random-effects model. The final effect size will be reported using the adjusted HR with a 95% CI.Ethics and disseminationEthical approval is not required for a protocol for a systematic review. The results of this systematic review will be published in a peer-reviewed journal and will be publicly available.PROSPERO registration numberCRD42021277741.

scholarly journals Predictors of Mortality among Patients Lost to Follow up Antiretroviral Therapy

Jurnal NERS ◽  
2018 ◽  
Vol 13 (1) ◽  
pp. 114 ◽  
Author(s):  
Putu Dian Prima Kusuma Dewi ◽  
Gede Budi Widiarta
Keyword(s):  
Incidence Rate ◽  
Median Time ◽  
Secondary Data ◽  
Primary Data ◽  
People Living With Hiv ◽  
Risk Of Death ◽  
Living With Hiv ◽  
Lost To Follow Up

Introduction: The death of HIV/AIDS patients after receiving therapy in Bali is the seventh highest percentage of deaths in Indonesia. LTFU increases the risk of death in PLHA, given the saturation of people with HIV taking medication. The level of consistency in the treatment is very important to maintain the resilience and quality of life of people living with HIV. This study aims to determine the incidence rate, median time and predictors of death occurring in LTFU patients as seen from their sociodemographic and clinical characteristics.Methods: This study used an analytical longitudinal approach with retrospective secondary data analysis in a cohort of HIV-positive patients receiving ARV therapy at the Buleleng District Hospital in the period 2006-2015. The study used the survival analysis available within the STATA SE 12 softwareResults: The result showed that the incidence rate of death in LTFU patients was 65.9 per 100 persons, with the median time occurrence of 0.2 years (2.53 months). The NNRTI-class antiretroviral evapirens agents were shown to increase the risk of incidence of death in LTFU patients 3.92 times greater than the nevirapine group (HR 3.92; p = 0.007 (CI 1.46-10.51). Each 1 kg increase in body weight decreased the risk of death in LTFU patients by 6% (HR 0.94; p = 0.035 (CI 0.89-0.99).Conclusion: An evaluation and the monitoring of patient tracking with LTFU should be undertaken to improve sustainability. Furthermore, an observation of the LTFU patient's final condition with primary data and qualitative research needs to be done so then it can explore more deeply the reasons behind LTFU.

scholarly journals Re-engagement in care of people living with HIV lost to follow-up after initiation of antiretroviral therapy in Mali: Who returns to care?

PLoS ONE ◽  
2020 ◽  
Vol 15 (9) ◽  
pp. e0238687
Author(s):  
Aliou Baldé ◽  
Laurence Lièvre ◽  
Almoustapha Issiaka Maiga ◽  
Fodié Diallo ◽  
Issouf Alassane Maiga ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
People Living With Hiv ◽  
Engagement In Care ◽  
Living With Hiv ◽  
Lost To Follow Up

scholarly journals Failure to return pillbox is a predictor of being lost to follow‐up among people living with HIV on antiretroviral therapy in rural Tanzania

HIV Medicine ◽  
2021 ◽  
Author(s):  
Robert C. Ndege ◽  
James Okuma ◽  
Aneth V. Kalinjuma ◽  
Julius Mkumbo ◽  
Elizabeth Senkoro ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
People Living With Hiv ◽  
Rural Tanzania ◽  
Living With Hiv ◽  
Lost To Follow Up

scholarly journals Cohort Profile: The Nigerian HIV Geriatric Cohort Study

2019 ◽  
Author(s):  
Gbenga Ayodele Kayode ◽  
Patrick Dakum ◽  
Yohanna Kambai Avong ◽  
Michael Kolawole Odutola ◽  
James Okuma ◽  
...  
Keyword(s):  
Hiv Treatment ◽  
People Living With Hiv ◽  
Art Initiation ◽  
Review Period ◽  
Level Data ◽  
Living With Hiv ◽  
Lost To Follow Up ◽  
Differentiated Care

Abstract Background: An estimated 280,000 adults aged 50 years and above live with HIV in Nigeria, a population set to increase with ART efficacy and expanding coverage. To learn how elderly people living with HIV (EPLHIV) in Nigeria fare, despite not being prioritized by the national treatment program, and to deepen knowledge for their differentiated care and achieve better outcomes, the Nigerian HIV Geriatric Cohort (NHGC) was setup. Methods: Patient-level data spanning the period 2004 to 2018, obtained from comprehensive HIV treatment hospitals, that are supported by four major PEPFAR-implementing partners in Nigeria was used. These 4 entities collaborated as member organizations of the Nigeria Implementation Science Alliance. We defined geriatric/elderly as those aged 50 years and above. From de-identified treatment records, demographic and clinical data of EPLHIV ≥50-year-old at ART initiation during the review period was extracted, merged into a single REDcap® database, and described using STATA 13. Results: A total of 101,652 unique EPLHIV entries were analysed. This cohort’s data was of 53,608 (52.7%) women, 51,037 (71.4%) of EPLHIV identified as married and 33,446 (51.1%) unemployed. Mean age was 57.1 years (SD=6.9) with average duration on ART as 4.6 years (SD=3.5). ART profile showed that 88,792 (95.7%) were on 1st-line and 55,905 (64.9%) were on TDF-based regimens. Mean-body mass index (BMI) was 23.0 kg/m2 (SD=5.4 kg/m2) with 56,010(55.1%), 19,619(19.3%) and 8844 (8.7%) showing normal (18.5kg/m2–24.9kg/m2), overweight (BMI 25- <30kg/m2) and obese (BMI ≥30kg/m2) ranges respectively. Hypertensive readings (systolic-BP >140mmHg or diastolic-BP >90mmHg) was found in 21,550 (21.2%) ELHIV records. Mean CD4 count was 420cells/µL (SD=285cells/µL) and 83,660(82.3%) had a viral load result showing <1000copies/ml. As for treatment outcomes, available records showed that 54.1% were active-in-treatment, 28.4% were lost-to-follow-up and 6.8% died. Poor population death records and aversion to autopsies makes it almost impossible to estimate AIDS-related deaths. Conclusions: The study described the clinical and non-clinical profile of EPLHIV in Nigeria. This study provides vital information for stakeholders in HIV prevention, care and treatment to understand the characteristics of EPLHIV. Findings from further analysis of this cohort will be applied to improve the quality of health of EPLHIV.

Traditional Chinese Medicine Could Increase the Survival of People Living with HIV in Rural Central China: A Retrospective Cohort Study, 2004–2012

2014 ◽  
Vol 42 (06) ◽  
pp. 1333-1344 ◽  
Author(s):  
Yantao Jin ◽  
Huijun Guo ◽  
Xin Wang ◽  
Xiumin Chen ◽  
Ziqiang Jiang ◽  
...  
Keyword(s):  
Cohort Study ◽  
Prognostic Factors ◽  
Chinese Medicine ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Therapy Group ◽  
People Living With Hiv ◽  
Living With Hiv ◽  
Lost To Follow Up

A retrospective cohort study was conducted to explore the effectiveness of Traditional Chinese Medicine (TCM) in treating people living with HIV (PLHIV) by comparing the survival of PLHIV treated with TCM and without TCM. To identify prognostic factors that affect the survival of PLHIV, patients who enrolled in the national TCM HIV treatment trial program (NTCMTP) in October 2004 and PLHIV in the same region who did not enroll in the NTCMTP were compared. Participants were followed up to October 2012. Survival time was estimated through the Kaplan–Meier method, and hazard ratios to identify prognostic factors were computed through Cox proportional hazard models. A total of 3,229 PLHIV (1,442 in the TCM therapy group and 1,787 in the non-TCM therapy group) were followed up for 21,876 person-years. In this time period, 751 (23.3%) died and 209 (6.5%) were lost to follow-up, for an overall mortality rate of 3.43/100 person-years. In the TCM therapy group, 287 (19.0%) died and 139 (9.7%) were lost to follow-up, and in the non-TCM therapy group, 464 (26.0%) PLHIV died and 70 (3.9%) were lost to follow-up. The mortality rate in the TCM therapy group was 2.97/100 person-years, which was lower than the rate of 3.79/100 person-years in the non-TCM therapy group. The 8-year cumulative survival in the TCM therapy group was 78.5%, lower than the 74.0% survival in the non-TCM therapy group. After adjusting for other factors, risk factors of death included male gender, older age, less education, taking combined antiretroviral therapy (cART) at enrollment, not taking cART at follow-up, and lower CD4 + T cell counts. Our retrospective cohort study indicates that TCM increased the survival and lengthened the lifetime of PLHIV in Henan Province of China. However, the limitations of a retrospective cohort could have biased the study, so prospective studies should be carried out to confirm our primary results.

scholarly journals Perception of People Living With HIV/AIDS Affecting Lost to Follow-Up of ARV Therapy

2019 ◽  
Vol 8 (1) ◽  
pp. 31
Author(s):  
Lilik Manowati ◽  
Purwaningsih Purwaningsih ◽  
Abu Bakar
Keyword(s):  
Self Efficacy ◽  
Antiretroviral Drugs ◽  
People Living With Hiv ◽  
Perceived Severity ◽  
Cues To Action ◽  
Living With Hiv ◽  
Lost To Follow Up ◽  
And Control ◽  
Hiv Aids

ABSTRACTIntroduction: HIV/AIDS sufferers must consume antiretrovirals every day and control routinely each month to take ARVs in the hospital. The condition make patients having a risk of lost to follow up attitude. The purpose of this study was to determine the factors related to the attitude of lost to follow-up on people living with hiv/aids with arv therapy at rsud dr. soetomo surabaya. Method: This study used descriptive correlation design with a cross-sectional approach. The population were 135 patients and 100 patients were required as research participant with consequtive sampling. Independent variables were perceived susceptibility, perceived severity, perceived barrier to action, perceived benefits of action, cues to action, and self efficacy. The dependent variable was lost to follow up behavior. Data were obtained by questionnaire and analyzed with Spearman's Rho. Result: There was a relationship between perceived susceptability (p=0.002), perceived severity (p=0.025), perceived barrier to action (p=0.022) and cues to action (p=0.011) with lost to follow-up behavior. There was no correlation between perceived benefit of action (p=0.196) and self efficacy (p=0.071) with lost to follow-up behavior. Discussion: Knowledge and awareness regarding the importance taking antiretroviral drugs regularly and control routinely needs to be increased for patients with antiretroviral drugs. Further researchers are advised to conduct in-depth research (qualitative research) related to the causes of lost to follow-up behaviour thus.

scholarly journals Conflicts in Yemen exacerbate lost to follow-up rates of people living with HIV

2018 ◽  
Author(s):  
Mayada Faisal Nabih M. ◽  
Sharifa E. Wan Puteh ◽  
Amrizal Muhammad Nur
Keyword(s):  
People Living With Hiv ◽  
Living With Hiv ◽  
Lost To Follow Up
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