Early loss to follow-up of recently diagnosed HIV-infected adults from routine pre-ART care in a rural district hospital in Kenya: a cohort study.
Early loss to follow-up of recently diagnosed HIV-infected adults from routine pre-ART care in a rural district hospital in Kenya: a cohort study.
复制标题
DOI：
10.1111/j.1365-3156.2011.02889.x
复制
发表时间：
2012-01
期刊：
影响因子：
--
通讯作者：
Berkley JA
中科院分区：
文献类型：
--
作者：
Hassan AS;Fielding KL;Thuo NM;Nabwera HM;Sanders EJ;Berkley JA
确定肯尼亚农村地区最近诊断为HIV感染、不符合抗逆转录病毒治疗（ART）条件的成年人早期失访（LTFU）的发生率和预测因素。前瞻性队列研究。对2008年7月至2009年8月期间登记接受艾滋病毒护理的客户进行了为期6个月的跟踪调查。基线数据用于评估ART前LTFU（在预定预约的2个月内未返回接受治疗）、第二次访视前LTFU和第二次访视后LTFU的预测因素。Logistic回归用于确定第二次访视前与LTFU相关的因素，而考克斯回归用于评估至LTFU的时间和第二次访视后LTFU的预测因素。在530名符合条件的客户中，178名（33.6%）是来自ART前护理的LTFU（11.1/100人月）。其中，96例（53.9%）在第二次访视前为LTFU。距离（>5 km vs. <1 km：校正的风险比2.6 [1.9-3.7]，P < 0.01）和婚姻状况（已婚vs.单身：0.5 [0.3-0.6]，P < 0.01）独立预测ART前LTFU。距离和婚姻状况与第二次就诊前的LTFU独立相关，而距离，教育状况和季节性在第二次就诊后预测LTFU的证据较弱。HIV疾病严重程度不能预测ART前LTFU。三分之一最近确诊的艾滋病毒感染者，不符合ART条件的客户在登记后6个月内进行了长期随访。不符合ART资格的客户中LTFU的预测因素与ART客户中的预测因素不同。这些发现值得考虑加强ART前护理方案，旨在提高保留率和及时启动ART。
To determine the rate and predictors of early loss to follow-up (LTFU) for recently diagnosed HIV-infected, antiretroviral therapy (ART)-ineligible adults in rural Kenya. Prospective cohort study. Clients registering for HIV care between July 2008 and August 2009 were followed up for 6 months. Baseline data were used to assess predictors of pre-ART LTFU (not returning for care within 2 months of a scheduled appointment), LTFU before the second visit and LTFU after the second visit. Logistic regression was used to determine factors associated with LTFU before the second visit, while Cox regression was used to assess predictors of time to LTFU and LTFU after the second visit. Of 530 eligible clients, 178 (33.6%) were LTFU from pre-ART care (11.1/100 person-months). Of these, 96 (53.9%) were LTFU before the second visit. Distance (>5 km vs. <1 km: adjusted hazard ratio 2.6 [1.9–3.7], P < 0.01) and marital status (married vs. single: 0.5 [0.3–0.6], P < 0.01) independently predicted pre-ART LTFU. Distance and marital status were independently associated with LTFU before the second visit, while distance, education status and seasonality showed weak evidence of predicting LTFU after the second visit. HIV disease severity did not predict pre-ART LTFU. A third of recently diagnosed HIV-infected, ART-ineligible clients were LTFU within 6 months of registration. Predictors of LTFU among ART-ineligible clients are different from those among clients on ART. These findings warrant consideration of an enhanced pre-ART care package aimed at improving retention and timely ART initiation.
登录
查看更多内容
影响因子：
120.7
作者：
Grant, AD;Charalambous, S;Churchyard, GJ
通讯作者：
Churchyard, GJ
影响因子：
3.7
作者：
Losina E;Bassett IV;Giddy J;Chetty S;Regan S;Walensky RP;Ross D;Scott CA;Uhler LM;Katz JN;Holst H;Freedberg KA
通讯作者：
Freedberg KA
DOI：
10.1097/qai.0b013e3182075ae2
发表时间：
2011-03-01
期刊：
Journal of acquired immune deficiency syndromes (1999)
影响因子：
--
作者：
Lessells RJ;Mutevedzi PC;Cooke GS;Newell ML
通讯作者：
Newell ML
影响因子：
3.8
作者：
Walson, Judd L.;Otieno, Phelgona A.;Mbuchi, Margaret;Richardson, Barbra A.;Lohman-Payne, Barbara;Macharia, Steve Wanyee;Overbaugh, Julie;Berkley, James;Sanders, Eduard J.;Chung, Michael H.;John-Stewart, Grace C.
通讯作者：
John-Stewart, Grace C.
DOI：
10.1097/01.aids.0000366081.91192.1c
发表时间：
2010-01
期刊：
AIDS (London, England)
影响因子：
--
作者：
Bassett IV;Regan S;Chetty S;Giddy J;Uhler LM;Holst H;Ross D;Katz JN;Walensky RP;Freedberg KA;Losina E
通讯作者：
Losina E