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DC Field | Value | Language |
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dc.contributor.author | Paula, Braitstein | - |
dc.date.accessioned | 2020-08-01T11:57:04Z | - |
dc.date.available | 2020-08-01T11:57:04Z | - |
dc.date.issued | 2016 | - |
dc.identifier.uri | http://ir.mu.ac.ke:8080/jspui/handle/123456789/3251 | - |
dc.description.abstract | Losses to follow-up (LTFU) remain an important programmatic challenge. While numerous patient-level factors have been associated with LTFU, less is known about facility-level fac- tors. Data from the East African International epidemiologic Databases to Evaluate AIDS (EA-IeDEA) Consortium was used to identify facility-level factors associated with LTFU in Kenya, Tanzania and Uganda. Patients were defined as LTFU if they had no visit within 12 months of the study endpoint for pre-ART patients or 6 months for patients on ART. Adjust- ing for patient factors, shared frailty proportional hazard models were used to identify the facility-level factors associated with LTFU for the pre- and post-ART periods. Data from 77,362 patients and 29 facilities were analyzed. Median age at enrolment was 36.0 years (Interquartile Range: 30.1, 43.1), 63.9% were women and 58.3% initiated ART. Rates (95% Confidence Interval) of LTFU were 25.1 (24.7 – 25.6) and 16.7 (16.3 – 17.2) per 100 person- years in the pre-ART and post-ART periods, respectively. Facility-level factors associated with increased LTFU included secondary-level care, HIV RNA PCR turnaround time > 14 days, and no onsite availability of CD4 testing. Increased LTFU was also observed when no nutritional supplements were provided (pre-ART only), when TB patients were treated within the HIV program (pre-ART only), and when the facility was open 4 mornings per week(ART only). Our findings suggest that facility-based strategies such as point of care labora- tory testing and separate clinic spaces for TB patients may improve retention. | en_US |
dc.language.iso | en | en_US |
dc.publisher | Crossmark | en_US |
dc.subject | HIV | en_US |
dc.title | Factors Influencing Retention of Patients in HIV Care in East Africa. | en_US |
dc.type | Article | en_US |
Appears in Collections: | School of Medicine |
Files in This Item:
File | Description | Size | Format | |
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Facility-Level Factors Influencing Retention | 261.65 kB | Adobe PDF | View/Open |
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