Four‐year retention and risk factors for attrition among members of community ART groups in T ete, M ozambique
Rattachement africain : Mozambique, be, gb. Niveau de preuve : code pays fourni par la source.
Le résumé fourni par la source
OBJECTIVE: Community ART groups (CAG), peer support groups involved in community ART distribution and mutual psychosocial support, were piloted to respond to staggering antiretroviral treatment (ART) attrition in Mozambique. To understand the impact of CAG on long-term retention, we estimated mortality and lost-to-follow-up (LTFU) rates and assessed predictors for attrition. METHODS: Retrospective cohort study. Kaplan-Meier techniques were used to estimate mortality and LTFU in CAG. Individual- and CAG-level predictors of attrition were assessed using a multivariable Cox proportional hazards model, adjusted for site-level clustering. RESULTS: Mortality and LTFU rates among 5729 CAG members were, respectively, 2.1 and 0.1 per 100 person-years. Retention was 97.7% at 12 months, 96.0% at 24 months, 93.4% at 36 months and 91.8% at 48 months. At individual level, attrition in CAG was significantly associated with immunosuppression when joining a CAG, and being male. At CAG level, attrition was associated with lack of rotational representation at the clinic, lack of a regular CD4 count among fellow members and linkage to a rural or district clinic compared with linkage to a peri-urban clinic. CONCLUSIONS: Long-term retention in this community-based ART model compares favourably with published data on stable ART patients. Nevertheless, to reduce attrition, further efforts need to be made to enroll patients earlier on ART, promote health-seeking behaviour, especially for men, promote a strong peer dynamic to assure rotational representation at the clinic and regular CD4 follow-up and reinforce referral of sick patients.
Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.
Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé, mais le titre doit être comparé manuellement.
- Titre Crossref
- Four‐year retention and risk factors for attrition among members of community <scp>ART</scp> groups in <scp>T</scp>ete, <scp>M</scp>ozambique
- Date Crossref
- 12/02/2014
- Éditeur
- Wiley
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Instituto Superior Politecnico de Tete Instituto Superior Politecnico de Tete, Mozambique (code pays fourni par la source)Université ou école supérieure
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Instituut voor Tropische Geneeskunde pays non établi dans la noticeOrganisme public
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London School of Hygiene & Tropical Medicine pays non établi dans la noticeUniversité ou école supérieure
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Médecins Sans Frontières Médecins Sans Frontières Tete Mozambique, Mozambique (pays nommé en fin d’affiliation)Organisation à but non lucratif
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Departement of Public Health Institute of Tropical Medicine Antwerp Belgium pays non établi dans la noticeStructure de recherche
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London School of Hygiene and Tropical Medicine London UK pays non établi dans la noticeUniversité ou école supérieure
Instituto Superior Politecnico de Tete (Instituto Superior Politecnico de Tete, Mozambique), Instituut voor Tropische Geneeskunde et London School of Hygiene & Tropical Medicine, avec 3 autres affiliations. Pays d’affiliation : Mozambique.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.