Lower Early Mortality Rates Among Patients Receiving Antiretroviral Treatment at Clinics Offering Cotrimoxazole Prophylaxis in Malawi
Lower Early Mortality Rates Among Patients Receiving Antiretroviral Treatment at Clinics Offering Cotrimoxazole Prophylaxis in Malawi
复制标题
在马拉维提供复方新诺明预防的诊所接受抗逆转录病毒治疗的患者早期死亡率较低
DOI：
10.1097/qai.0b013e3181378ed2
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发表时间：
2007
期刊：
影响因子：
--
通讯作者：
Edwin Libamba
中科院分区：
文献类型：
--
作者：
David W Lowrance;S. Makombe;A. Harries;J. Yu;J. Aberle‐grasse;Odette Eiger;R. Shiraishi;B. Marston;T. Ellerbrock;Edwin Libamba
目的：确定马拉维提供复方新诺明（CTX）预防的抗逆转录病毒治疗（ART）诊所与不提供CTX的诊所相比，早期死亡率是否较低。方法：回顾性队列研究11 ART诊所在马拉维，或不提供CTX。对2005年7月1日至12月15日期间开始ART的所有患者（N = 1295）进行病历提取。在5个ART中心，CTX以每天960 mg或每天两次480 mg的剂量给予患者（根据国家指南）。结果：当从分析中排除所有违约（患者失访>90天）时，在CTX诊所接受ART的患者6个月死亡率为10.7%，而未在CTX诊所接受ART的患者为18.0%（6个月死亡风险降低= 40.7%; P = 0.0013）。Kaplan-Meier生存曲线接受CTX的患者和未接受CTX的患者有显着差异，生存差异是明显的，早在40至45天后开始的ART. Conclusions：在马拉维接受ART的患者在诊所提供CTX预防有显着降低死亡率在第一个6个月的ART。这种额外的干预可能有潜力改善ART患者的生活，因为CTX是现成的，相对便宜，可以，在原则上，很容易引入ART交付计划。
Objective:To determine whether Malawi antiretroviral treatment (ART) clinics providing cotrimoxazole (CTX) prophylaxis had lower early mortality rates compared with clinics not providing CTX. Methods:Retrospective cohort study of eleven ART clinics in Malawi that were or were not providing CTX. Medical record abstraction was performed for all patients (N = 1295) initiating ART between July 1 and December 15, 2005. At 5 ART sites, CTX was given to patients dosed at 960 mg daily or 480 mg twice a day (according to national guidelines). Results:When all defaults (patients lost to follow-up for >90 days) were excluded from the analysis, the 6-month mortality rate was 10.7% in patients receiving ART at CTX clinics compared with 18.0% in those not at CTX clinics (6-month mortality risk reduction = 40.7%; P = 0.0013). Kaplan-Meier survival curves for patients receiving CTX and patients not receiving CTX were significantly different; survival differences were apparent as early as 40 to 45 days after initiation of ART. Conclusions:Patients receiving ART in Malawi at clinics offering CTX prophylaxis had significantly reduced mortality during the first 6 months of ART. This additional intervention may have the potential to improve the lives of patients on ART, because CTX is readily available and relatively inexpensive and can, in principle, be easily introduced into ART delivery programs.
影响因子：
158.5
作者：
Goldie, Sue J.;Yazdanpanah, Yazdan;Freedberg, Kenneth A.
通讯作者：
Freedberg, Kenneth A.
影响因子：
120.7
作者：
Stringer, Jeffrey S. A.;Zulu, Isaac;Sinkala, Moses
通讯作者：
Sinkala, Moses