Outcomes of HIV-positive patients lost to follow-up in African treatment programmes
Identifieur interne : 000469 ( Main/Exploration ); précédent : 000468; suivant : 000470Outcomes of HIV-positive patients lost to follow-up in African treatment programmes
Auteurs : Kathrin Zürcher [Suisse] ; Anne Mooser [Suisse] ; Nanina Anderegg [Suisse] ; Olga Tymejczyk [États-Unis] ; Margaret J. Couvillon [Suisse] ; Denis Nash [États-Unis] ; Matthias Egger [Suisse, Afrique du Sud]Source :
- Tropical medicine & international health : TM & IH [ 1360-2276 ] ; 2017.
Abstract
The retention of patients on antiretroviral therapy (ART) is key to achieving global targets in response to the HIV epidemic. Loss to follow-up (LTFU) can be substantial, with unknown outcomes for patients lost to ART programmes. We examined changes in outcomes of patients LTFU over calendar time, assessed associations with other study and programme characteristics and investigated the relative success of different tracing methods.
We performed a systematic review and logistic random-effects meta-regression analysis of studies that traced adults or children who started ART and were LTFU in sub-Saharan African treatment programmes. The primary outcome was mortality, and secondary outcomes were undocumented transfer to another programme, treatment interruption and the success of tracing attempts.
We included 32 eligible studies from 12 countries in sub-Saharan Africa: 20 365 patients LTFU were traced, and 15 708 patients (77.1%) were found. Compared to telephone calls, tracing that included home visits increased the probability of success: the adjusted odds ratio (aOR) was 9.35 (95% confidence interval [CI] 1.85–47.31). The risk of death declined over calendar time (aOR per 1-year increase 0.86, 95% CI 0.78–0.95), whereas undocumented transfers (aOR 1.13, 95% CI 0.96–1.34) and treatment interruptions (aOR 1.31, 95% CI 1.18–1.45) tended to increase. Mortality was lower in urban than in rural areas (aOR 0.59, 95% CI 0.36–0.98), but there was no difference in mortality between adults and children. The CD4 cell count at the start of ART increased over time.
Mortality among HIV-positive patients who started ART in sub-Saharan Africa, were lost to programmes and were successfully traced has declined substantially during the scale-up of ART, probably driven by less severe immunodeficiency at the start of therapy.
Url:
DOI: 10.1111/tmi.12843
PubMed: 28102610
PubMed Central: 5580236
Affiliations:
Links toward previous steps (curation, corpus...)
- to stream Pmc, to step Corpus: 001F17
- to stream Pmc, to step Curation: 001F16
- to stream Pmc, to step Checkpoint: 000129
- to stream Ncbi, to step Merge: 003C85
- to stream Ncbi, to step Curation: 003C85
- to stream Ncbi, to step Checkpoint: 003C85
- to stream Main, to step Merge: 000469
- to stream Main, to step Curation: 000469
Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Outcomes of HIV-positive patients lost to follow-up in African treatment programmes</title>
<author><name sortKey="Zurcher, Kathrin" sort="Zurcher, Kathrin" uniqKey="Zurcher K" first="Kathrin" last="Zürcher">Kathrin Zürcher</name>
<affiliation wicri:level="4"><nlm:aff id="A1">Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland</nlm:aff>
<country xml:lang="fr">Suisse</country>
<wicri:regionArea>Institute of Social and Preventive Medicine, University of Bern, Bern</wicri:regionArea>
<placeName><settlement type="city">Berne</settlement>
<region type="région" nuts="3">Canton de Berne</region>
<settlement type="city">Berne</settlement>
</placeName>
<orgName type="university">Université de Berne</orgName>
</affiliation>
</author>
<author><name sortKey="Mooser, Anne" sort="Mooser, Anne" uniqKey="Mooser A" first="Anne" last="Mooser">Anne Mooser</name>
<affiliation wicri:level="4"><nlm:aff id="A1">Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland</nlm:aff>
<country xml:lang="fr">Suisse</country>
<wicri:regionArea>Institute of Social and Preventive Medicine, University of Bern, Bern</wicri:regionArea>
<placeName><settlement type="city">Berne</settlement>
<region type="région" nuts="3">Canton de Berne</region>
<settlement type="city">Berne</settlement>
</placeName>
<orgName type="university">Université de Berne</orgName>
</affiliation>
</author>
<author><name sortKey="Anderegg, Nanina" sort="Anderegg, Nanina" uniqKey="Anderegg N" first="Nanina" last="Anderegg">Nanina Anderegg</name>
<affiliation wicri:level="4"><nlm:aff id="A1">Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland</nlm:aff>
<country xml:lang="fr">Suisse</country>
<wicri:regionArea>Institute of Social and Preventive Medicine, University of Bern, Bern</wicri:regionArea>
<placeName><settlement type="city">Berne</settlement>
<region type="région" nuts="3">Canton de Berne</region>
<settlement type="city">Berne</settlement>
</placeName>
<orgName type="university">Université de Berne</orgName>
</affiliation>
</author>
<author><name sortKey="Tymejczyk, Olga" sort="Tymejczyk, Olga" uniqKey="Tymejczyk O" first="Olga" last="Tymejczyk">Olga Tymejczyk</name>
<affiliation wicri:level="2"><nlm:aff id="A2">Institute for Implementation Science in Population Health, City University of New York, New York, NY, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Institute for Implementation Science in Population Health, City University of New York, New York, NY</wicri:regionArea>
<placeName><region type="state">État de New York</region>
</placeName>
</affiliation>
<affiliation wicri:level="2"><nlm:aff id="A3">Department of Epidemiology and Biostatistics, City University of New York School of Public Health, New York, NY, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Epidemiology and Biostatistics, City University of New York School of Public Health, New York, NY</wicri:regionArea>
<placeName><region type="state">État de New York</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Couvillon, Margaret J" sort="Couvillon, Margaret J" uniqKey="Couvillon M" first="Margaret J." last="Couvillon">Margaret J. Couvillon</name>
<affiliation wicri:level="4"><nlm:aff id="A1">Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland</nlm:aff>
<country xml:lang="fr">Suisse</country>
<wicri:regionArea>Institute of Social and Preventive Medicine, University of Bern, Bern</wicri:regionArea>
<placeName><settlement type="city">Berne</settlement>
<region type="région" nuts="3">Canton de Berne</region>
<settlement type="city">Berne</settlement>
</placeName>
<orgName type="university">Université de Berne</orgName>
</affiliation>
</author>
<author><name sortKey="Nash, Denis" sort="Nash, Denis" uniqKey="Nash D" first="Denis" last="Nash">Denis Nash</name>
<affiliation wicri:level="2"><nlm:aff id="A2">Institute for Implementation Science in Population Health, City University of New York, New York, NY, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Institute for Implementation Science in Population Health, City University of New York, New York, NY</wicri:regionArea>
<placeName><region type="state">État de New York</region>
</placeName>
</affiliation>
<affiliation wicri:level="2"><nlm:aff id="A3">Department of Epidemiology and Biostatistics, City University of New York School of Public Health, New York, NY, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Epidemiology and Biostatistics, City University of New York School of Public Health, New York, NY</wicri:regionArea>
<placeName><region type="state">État de New York</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Egger, Matthias" sort="Egger, Matthias" uniqKey="Egger M" first="Matthias" last="Egger">Matthias Egger</name>
<affiliation wicri:level="4"><nlm:aff id="A1">Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland</nlm:aff>
<country xml:lang="fr">Suisse</country>
<wicri:regionArea>Institute of Social and Preventive Medicine, University of Bern, Bern</wicri:regionArea>
<placeName><settlement type="city">Berne</settlement>
<region type="région" nuts="3">Canton de Berne</region>
<settlement type="city">Berne</settlement>
</placeName>
<orgName type="university">Université de Berne</orgName>
</affiliation>
<affiliation wicri:level="1"><nlm:aff id="A4">Centre for Infectious Disease Epidemiology and Research, University of Cape Town, Cape Town, South Africa</nlm:aff>
<country xml:lang="fr">Afrique du Sud</country>
<wicri:regionArea>Centre for Infectious Disease Epidemiology and Research, University of Cape Town, Cape Town</wicri:regionArea>
<wicri:noRegion>Cape Town</wicri:noRegion>
</affiliation>
</author>
</titleStmt>
<publicationStmt><idno type="wicri:source">PMC</idno>
<idno type="pmid">28102610</idno>
<idno type="pmc">5580236</idno>
<idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5580236</idno>
<idno type="RBID">PMC:5580236</idno>
<idno type="doi">10.1111/tmi.12843</idno>
<date when="2017">2017</date>
<idno type="wicri:Area/Pmc/Corpus">001F17</idno>
<idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">001F17</idno>
<idno type="wicri:Area/Pmc/Curation">001F16</idno>
<idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">001F16</idno>
<idno type="wicri:Area/Pmc/Checkpoint">000129</idno>
<idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">000129</idno>
<idno type="wicri:Area/Ncbi/Merge">003C85</idno>
<idno type="wicri:Area/Ncbi/Curation">003C85</idno>
<idno type="wicri:Area/Ncbi/Checkpoint">003C85</idno>
<idno type="wicri:doubleKey">1360-2276:2017:Zurcher K:outcomes:of:hiv</idno>
<idno type="wicri:Area/Main/Merge">000469</idno>
<idno type="wicri:Area/Main/Curation">000469</idno>
<idno type="wicri:Area/Main/Exploration">000469</idno>
</publicationStmt>
<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Outcomes of HIV-positive patients lost to follow-up in African treatment programmes</title>
<author><name sortKey="Zurcher, Kathrin" sort="Zurcher, Kathrin" uniqKey="Zurcher K" first="Kathrin" last="Zürcher">Kathrin Zürcher</name>
<affiliation wicri:level="4"><nlm:aff id="A1">Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland</nlm:aff>
<country xml:lang="fr">Suisse</country>
<wicri:regionArea>Institute of Social and Preventive Medicine, University of Bern, Bern</wicri:regionArea>
<placeName><settlement type="city">Berne</settlement>
<region type="région" nuts="3">Canton de Berne</region>
<settlement type="city">Berne</settlement>
</placeName>
<orgName type="university">Université de Berne</orgName>
</affiliation>
</author>
<author><name sortKey="Mooser, Anne" sort="Mooser, Anne" uniqKey="Mooser A" first="Anne" last="Mooser">Anne Mooser</name>
<affiliation wicri:level="4"><nlm:aff id="A1">Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland</nlm:aff>
<country xml:lang="fr">Suisse</country>
<wicri:regionArea>Institute of Social and Preventive Medicine, University of Bern, Bern</wicri:regionArea>
<placeName><settlement type="city">Berne</settlement>
<region type="région" nuts="3">Canton de Berne</region>
<settlement type="city">Berne</settlement>
</placeName>
<orgName type="university">Université de Berne</orgName>
</affiliation>
</author>
<author><name sortKey="Anderegg, Nanina" sort="Anderegg, Nanina" uniqKey="Anderegg N" first="Nanina" last="Anderegg">Nanina Anderegg</name>
<affiliation wicri:level="4"><nlm:aff id="A1">Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland</nlm:aff>
<country xml:lang="fr">Suisse</country>
<wicri:regionArea>Institute of Social and Preventive Medicine, University of Bern, Bern</wicri:regionArea>
<placeName><settlement type="city">Berne</settlement>
<region type="région" nuts="3">Canton de Berne</region>
<settlement type="city">Berne</settlement>
</placeName>
<orgName type="university">Université de Berne</orgName>
</affiliation>
</author>
<author><name sortKey="Tymejczyk, Olga" sort="Tymejczyk, Olga" uniqKey="Tymejczyk O" first="Olga" last="Tymejczyk">Olga Tymejczyk</name>
<affiliation wicri:level="2"><nlm:aff id="A2">Institute for Implementation Science in Population Health, City University of New York, New York, NY, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Institute for Implementation Science in Population Health, City University of New York, New York, NY</wicri:regionArea>
<placeName><region type="state">État de New York</region>
</placeName>
</affiliation>
<affiliation wicri:level="2"><nlm:aff id="A3">Department of Epidemiology and Biostatistics, City University of New York School of Public Health, New York, NY, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Epidemiology and Biostatistics, City University of New York School of Public Health, New York, NY</wicri:regionArea>
<placeName><region type="state">État de New York</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Couvillon, Margaret J" sort="Couvillon, Margaret J" uniqKey="Couvillon M" first="Margaret J." last="Couvillon">Margaret J. Couvillon</name>
<affiliation wicri:level="4"><nlm:aff id="A1">Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland</nlm:aff>
<country xml:lang="fr">Suisse</country>
<wicri:regionArea>Institute of Social and Preventive Medicine, University of Bern, Bern</wicri:regionArea>
<placeName><settlement type="city">Berne</settlement>
<region type="région" nuts="3">Canton de Berne</region>
<settlement type="city">Berne</settlement>
</placeName>
<orgName type="university">Université de Berne</orgName>
</affiliation>
</author>
<author><name sortKey="Nash, Denis" sort="Nash, Denis" uniqKey="Nash D" first="Denis" last="Nash">Denis Nash</name>
<affiliation wicri:level="2"><nlm:aff id="A2">Institute for Implementation Science in Population Health, City University of New York, New York, NY, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Institute for Implementation Science in Population Health, City University of New York, New York, NY</wicri:regionArea>
<placeName><region type="state">État de New York</region>
</placeName>
</affiliation>
<affiliation wicri:level="2"><nlm:aff id="A3">Department of Epidemiology and Biostatistics, City University of New York School of Public Health, New York, NY, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Epidemiology and Biostatistics, City University of New York School of Public Health, New York, NY</wicri:regionArea>
<placeName><region type="state">État de New York</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Egger, Matthias" sort="Egger, Matthias" uniqKey="Egger M" first="Matthias" last="Egger">Matthias Egger</name>
<affiliation wicri:level="4"><nlm:aff id="A1">Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland</nlm:aff>
<country xml:lang="fr">Suisse</country>
<wicri:regionArea>Institute of Social and Preventive Medicine, University of Bern, Bern</wicri:regionArea>
<placeName><settlement type="city">Berne</settlement>
<region type="région" nuts="3">Canton de Berne</region>
<settlement type="city">Berne</settlement>
</placeName>
<orgName type="university">Université de Berne</orgName>
</affiliation>
<affiliation wicri:level="1"><nlm:aff id="A4">Centre for Infectious Disease Epidemiology and Research, University of Cape Town, Cape Town, South Africa</nlm:aff>
<country xml:lang="fr">Afrique du Sud</country>
<wicri:regionArea>Centre for Infectious Disease Epidemiology and Research, University of Cape Town, Cape Town</wicri:regionArea>
<wicri:noRegion>Cape Town</wicri:noRegion>
</affiliation>
</author>
</analytic>
<series><title level="j">Tropical medicine & international health : TM & IH</title>
<idno type="ISSN">1360-2276</idno>
<idno type="eISSN">1365-3156</idno>
<imprint><date when="2017">2017</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
</fileDesc>
<profileDesc><textClass></textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en"><sec id="S1"><title>OBJECTIVE</title>
<p id="P1">The retention of patients on antiretroviral therapy (ART) is key to achieving global targets in response to the HIV epidemic. Loss to follow-up (LTFU) can be substantial, with unknown outcomes for patients lost to ART programmes. We examined changes in outcomes of patients LTFU over calendar time, assessed associations with other study and programme characteristics and investigated the relative success of different tracing methods.</p>
</sec>
<sec id="S2"><title>METHODS</title>
<p id="P2">We performed a systematic review and logistic random-effects meta-regression analysis of studies that traced adults or children who started ART and were LTFU in sub-Saharan African treatment programmes. The primary outcome was mortality, and secondary outcomes were undocumented transfer to another programme, treatment interruption and the success of tracing attempts.</p>
</sec>
<sec id="S3"><title>RESULTS</title>
<p id="P3">We included 32 eligible studies from 12 countries in sub-Saharan Africa: 20 365 patients LTFU were traced, and 15 708 patients (77.1%) were found. Compared to telephone calls, tracing that included home visits increased the probability of success: the adjusted odds ratio (aOR) was 9.35 (95% confidence interval [CI] 1.85–47.31). The risk of death declined over calendar time (aOR per 1-year increase 0.86, 95% CI 0.78–0.95), whereas undocumented transfers (aOR 1.13, 95% CI 0.96–1.34) and treatment interruptions (aOR 1.31, 95% CI 1.18–1.45) tended to increase. Mortality was lower in urban than in rural areas (aOR 0.59, 95% CI 0.36–0.98), but there was no difference in mortality between adults and children. The CD4 cell count at the start of ART increased over time.</p>
</sec>
<sec id="S4"><title>CONCLUSIONS</title>
<p id="P4">Mortality among HIV-positive patients who started ART in sub-Saharan Africa, were lost to programmes and were successfully traced has declined substantially during the scale-up of ART, probably driven by less severe immunodeficiency at the start of therapy.</p>
</sec>
</div>
</front>
</TEI>
<affiliations><list><country><li>Afrique du Sud</li>
<li>Suisse</li>
<li>États-Unis</li>
</country>
<region><li>Canton de Berne</li>
<li>État de New York</li>
</region>
<settlement><li>Berne</li>
</settlement>
<orgName><li>Université de Berne</li>
</orgName>
</list>
<tree><country name="Suisse"><region name="Canton de Berne"><name sortKey="Zurcher, Kathrin" sort="Zurcher, Kathrin" uniqKey="Zurcher K" first="Kathrin" last="Zürcher">Kathrin Zürcher</name>
</region>
<name sortKey="Anderegg, Nanina" sort="Anderegg, Nanina" uniqKey="Anderegg N" first="Nanina" last="Anderegg">Nanina Anderegg</name>
<name sortKey="Couvillon, Margaret J" sort="Couvillon, Margaret J" uniqKey="Couvillon M" first="Margaret J." last="Couvillon">Margaret J. Couvillon</name>
<name sortKey="Egger, Matthias" sort="Egger, Matthias" uniqKey="Egger M" first="Matthias" last="Egger">Matthias Egger</name>
<name sortKey="Mooser, Anne" sort="Mooser, Anne" uniqKey="Mooser A" first="Anne" last="Mooser">Anne Mooser</name>
</country>
<country name="États-Unis"><region name="État de New York"><name sortKey="Tymejczyk, Olga" sort="Tymejczyk, Olga" uniqKey="Tymejczyk O" first="Olga" last="Tymejczyk">Olga Tymejczyk</name>
</region>
<name sortKey="Nash, Denis" sort="Nash, Denis" uniqKey="Nash D" first="Denis" last="Nash">Denis Nash</name>
<name sortKey="Nash, Denis" sort="Nash, Denis" uniqKey="Nash D" first="Denis" last="Nash">Denis Nash</name>
<name sortKey="Tymejczyk, Olga" sort="Tymejczyk, Olga" uniqKey="Tymejczyk O" first="Olga" last="Tymejczyk">Olga Tymejczyk</name>
</country>
<country name="Afrique du Sud"><noRegion><name sortKey="Egger, Matthias" sort="Egger, Matthias" uniqKey="Egger M" first="Matthias" last="Egger">Matthias Egger</name>
</noRegion>
</country>
</tree>
</affiliations>
</record>
Pour manipuler ce document sous Unix (Dilib)
EXPLOR_STEP=$WICRI_ROOT/Wicri/Sante/explor/SidaSubSaharaV1/Data/Main/Exploration
HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 000469 | SxmlIndent | more
Ou
HfdSelect -h $EXPLOR_AREA/Data/Main/Exploration/biblio.hfd -nk 000469 | SxmlIndent | more
Pour mettre un lien sur cette page dans le réseau Wicri
{{Explor lien |wiki= Wicri/Sante |area= SidaSubSaharaV1 |flux= Main |étape= Exploration |type= RBID |clé= PMC:5580236 |texte= Outcomes of HIV-positive patients lost to follow-up in African treatment programmes }}
Pour générer des pages wiki
HfdIndexSelect -h $EXPLOR_AREA/Data/Main/Exploration/RBID.i -Sk "pubmed:28102610" \ | HfdSelect -Kh $EXPLOR_AREA/Data/Main/Exploration/biblio.hfd \ | NlmPubMed2Wicri -a SidaSubSaharaV1
This area was generated with Dilib version V0.6.32. |