Please use this identifier to cite or link to this item: https://hdl.handle.net/1959.11/16558
Title: Characteristics and Outcomes of Adult Patients Lost to Follow-Up at an Antiretroviral Treatment Clinic in Johannesburg, South Africa
Contributor(s): Dalal, Rishikesh P (author); MacPhail, Catherine  (author)orcid ; Mqhayi, Mmabatho (author); Wing, Jeff (author); Feldman, Charles (author); Chersich, Matthew F (author); Venter, Willem D F (author)
Publication Date: 2008
DOI: 10.1097/QAI.0b013e31815b833a
Handle Link: https://hdl.handle.net/1959.11/16558
Abstract: Background: A significant proportion of those initiating antiretroviral treatment (ART) for HIV infection are lost to follow-up. Causes for discontinuing ART follow-up in resource-limited settings are not well understood. Methods: A retrospective analysis was conducted of all adult patients receiving ART at an urban public clinic in Johannesburg, South Africa between April 2004 and June 2005. Patients discontinuing follow-up for at least 6 weeks were identified and further studied, and causes for treatment default were tabulated. Results: Of 1631 adult patients studied, 267 (16.4%) discontinued follow-up during the study period. Gender, ethnicity, and age were not predictive of loss to follow-up. Of those discontinuing follow-up, 173 (64.8%) were successfully traced. Death accounted for 48% (n = 83) of those traced. Characteristics associated with death were older age at ART initiation ('P' = 0.022), lower baseline CD4 cell count ('P' = 0.0073), higher initial HIV RNA load ('P' = 0.024), and loss of weight on ART ('P' = 0.033). Date of death was known for 71% (n = 59) of patients traced deceased, of whom 83% (n = 49) had died within 30 days of active ART. Common nonmortality losses included relocation or clinic transfer (25.4%) and hospitalization or illness not resulting in death (10.4%). Few cited financial difficulty or medication toxicity as reasons for discontinuing follow-up. Conclusions: Nearly 1 in 6 patients receiving ART in a resource constrained setting had discontinued follow-up over a 15-month period. Early mortality was high, especially in those with profound immunosuppression. Improving access to care and streamlining patient tracking may improve ART outcomes.
Publication Type: Journal Article
Source of Publication: Journal of Acquired Immune Deficiency Syndromes, 47(1), p. 101-107
Publisher: Lippincott Williams & Wilkins
Place of Publication: United States of America
ISSN: 1944-7884
1525-4135
Field of Research (FOR): 119999 Medical and Health Sciences not elsewhere classified
110309 Infectious Diseases
Peer Reviewed: Yes
HERDC Category Description: C1 Refereed Article in a Scholarly Journal
Statistics to Oct 2018: Visitors: 231
Views: 247
Downloads: 0
Appears in Collections:Journal Article

Files in This Item:
2 files
File Description SizeFormat 
Show full item record

SCOPUSTM   
Citations

45
checked on Nov 30, 2018

Page view(s)

50
checked on May 2, 2019
Google Media

Google ScholarTM

Check

Altmetric


Items in Research UNE are protected by copyright, with all rights reserved, unless otherwise indicated.