Loss to follow-up before and after initiation of antiretroviral therapy in HIV facilities in Lilongwe, Malawi

作者：Hannock Tweya, Ikwo Oboho, Salem Gugsa, Sam Phiri, Ethel Rambiki, Rebecca Banda, Johnbosco Mwafilaso, Chimango Munthali, Sundeep Gupta, Moses Bateganya, Alice Maida · 发表于：PLoS ONE · 年份：2018 · DOI：10.1371/journal.pone.0188488 · 被引用次数：102 · 研究领域：HIV/AIDS Research and Interventions、HIV/AIDS drug development and treatment、Pneumocystis jirovecii pneumonia detection and treatment

INTRODUCTION: Although several studies have explored factors associated with loss to follow-up (LTFU) from HIV care, there remains a gap in understanding how these factors vary by setting, volume of patient and patients' demographic and clinical characteristics. We determined rates and factors associated with LTFU in HIV care Lilongwe, Malawi. METHODS: We conducted a retrospective cohort study of HIV-infected individuals aged 15 years or older at the time of registration for HIV care in 12 ART facilities, between April 2012 and March 2013. HIV-positive individuals who had not started ART (pre-ART patients) were clinically assessed to determine ART eligibility at registration and during clinic follow-up visits. ART-eligible patients were initiated on triple antiretroviral combination. Study data were abstracted from patients' cards, facility ART registers or electronic medical record system from the date of registration for HIV care to a maximum follow-up period of 24 months. Descriptive statistics were undertaken to summarize characteristics of the study patients. Separate univariable and multivariable poisson regression models were used to explore factors associated with LTFU in pre-ART and ART care. RESULTS: A total of 10,812 HIV-infected individuals registered for HIV care. Of these patients, 1,907 (18%) and 8,905 (82%) enrolled in pre-ART and ART care, respectively. Of the 1,907 pre-ART patients, 490 (26%) subsequently initiated ART and were included in both the pre-ART a...