Decentralizing ART supply for stable HIV patients to community-based distribution centres: Programme outcomes from an urban context in Kinshasa, DRC.
Identifieur interne : 000010 ( OpenAccess/Analysis ); précédent : 000009; suivant : 000011Decentralizing ART supply for stable HIV patients to community-based distribution centres: Programme outcomes from an urban context in Kinshasa, DRC.
Auteurs : Florian Vogt [Suisse] ; Lucien Kalenga ; Jean Lukela ; Freddy Salumu ; Ibrahim Diallo ; Elena Nico ; Emmanuel Lampart ; Rafael Van Den Bergh ; Safieh Shah ; Olumide Ogundahunsi ; Rony Zachariah ; Johan Van GriensvenSource :
- Journal of acquired immune deficiency syndromes (1999) [ 1944-7884 ] ; 2016.
Abstract
Facility-based ART provision for stable HIV patients congests health services in resource-limited countries. We assessed outcomes and risk factors for attrition after decentralization to community-based ART refill centres among 2,603 HIV patients in Kinshasa, DRC using a multi-level Poisson regression model. Death, loss to follow-up, and transfer-out was 0.3%, 9.0%, and 0.7% at 24 months. Overall attrition was 5.66/100py. Patients with >3 years on ART, >500 CD4 count, BMI >18.5, and receiving nevirapine but not stavudine showed reduced attrition. ART refill centres are a promising task-shifting model in low-prevalence urban settings with high levels of stigma and poor ART coverage.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
DOI: 10.1097/QAI.0000000000001215
PubMed: 27787343
Affiliations:
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last="Vogt">Florian Vogt</name><affiliation wicri:level="1"><nlm:affiliation>1Institute of Tropical Medicine Antwerp (Antwerp, Belgium) 2Doctors Without Borders / Médecins Sans Frontiéres (Kinshasa, DRC) 3Réseau National des Organisations d`Assise Communautaires (Kinshasa, DRC) 4National Programme against HIV/AIDS DRC (Kinshasa, DRC) 5Doctors Without Borders (Brussels, Belgium) 6World Health Organization (Geneva, Switzerland).</nlm:affiliation><country xml:lang="fr" wicri:curation="lc">Suisse</country><wicri:regionArea>1Institute of Tropical Medicine Antwerp (Antwerp, Belgium) 2Doctors Without Borders / Médecins Sans Frontiéres (Kinshasa, DRC) 3Réseau National des Organisations d`Assise Communautaires (Kinshasa, DRC) 4National Programme against HIV/AIDS DRC (Kinshasa, DRC) 5Doctors Without Borders (Brussels, Belgium) 6World Health Organization (Geneva</wicri:regionArea><wicri:noRegion>Belgium) 6World Health Organization (Geneva</wicri:noRegion></affiliation></author><author><name 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congests health services in resource-limited countries. We assessed outcomes and risk factors for attrition after decentralization to community-based ART refill centres among 2,603 HIV patients in Kinshasa, DRC using a multi-level Poisson regression model. Death, loss to follow-up, and transfer-out was 0.3%, 9.0%, and 0.7% at 24 months. Overall attrition was 5.66/100py. Patients with >3 years on ART, >500 CD4 count, BMI >18.5, and receiving nevirapine but not stavudine showed reduced attrition. ART refill centres are a promising task-shifting model in low-prevalence urban settings with high levels of stigma and poor ART coverage.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.</div></front></TEI><affiliations><list><country><li>Suisse</li></country></list><tree><noCountry><name sortKey="Diallo, Ibrahim" sort="Diallo, Ibrahim" uniqKey="Diallo I" first="Ibrahim" last="Diallo">Ibrahim Diallo</name><name sortKey="Kalenga, Lucien" sort="Kalenga, Lucien" uniqKey="Kalenga L" first="Lucien" last="Kalenga">Lucien Kalenga</name><name sortKey="Lampart, Emmanuel" sort="Lampart, Emmanuel" uniqKey="Lampart E" first="Emmanuel" last="Lampart">Emmanuel Lampart</name><name sortKey="Lukela, Jean" sort="Lukela, Jean" uniqKey="Lukela J" first="Jean" last="Lukela">Jean Lukela</name><name sortKey="Nico, Elena" sort="Nico, Elena" uniqKey="Nico E" first="Elena" last="Nico">Elena Nico</name><name sortKey="Ogundahunsi, Olumide" sort="Ogundahunsi, Olumide" uniqKey="Ogundahunsi O" first="Olumide" last="Ogundahunsi">Olumide Ogundahunsi</name><name sortKey="Salumu, Freddy" sort="Salumu, Freddy" uniqKey="Salumu F" first="Freddy" last="Salumu">Freddy Salumu</name><name sortKey="Shah, Safieh" sort="Shah, Safieh" uniqKey="Shah S" first="Safieh" last="Shah">Safieh Shah</name><name sortKey="Van Den Bergh, Rafael" sort="Van Den Bergh, Rafael" uniqKey="Van Den Bergh R" first="Rafael" last="Van Den Bergh">Rafael Van Den Bergh</name><name sortKey="Van Griensven, Johan" sort="Van Griensven, Johan" uniqKey="Van Griensven J" first="Johan" last="Van Griensven">Johan Van Griensven</name><name sortKey="Zachariah, Rony" sort="Zachariah, Rony" uniqKey="Zachariah R" first="Rony" last="Zachariah">Rony Zachariah</name></noCountry><country name="Suisse"><noRegion><name sortKey="Vogt, Florian" sort="Vogt, Florian" uniqKey="Vogt F" first="Florian" last="Vogt">Florian Vogt</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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