Neuropsychiatric and Socioeconomic Status Impact Antiretroviral Adherence and Mortality in Rural Zambia
Identifieur interne : 001618 ( Pmc/Corpus ); précédent : 001617; suivant : 001619Neuropsychiatric and Socioeconomic Status Impact Antiretroviral Adherence and Mortality in Rural Zambia
Auteurs : Gretchen L. Birbeck ; Michelle P. Kvalsund ; Peter A. Byers ; Richard Bradbury ; Charles Mang'Ombe ; Natalie Organek ; Trevor Kaile ; Alex M. Sinyama ; Sylvester S. Sinyangwe ; Kennedy Malama ; Costantine MalamaSource :
- The American Journal of Tropical Medicine and Hygiene [ 0002-9637 ] ; 2011.
Abstract
We conducted a prospective cohort study of 496 adults starting antiretroviral treatment (ART) to determine the impact of neuropsychiatric symptoms and socioeconomic status on adherence and mortality. Almost 60% had good adherence based upon pharmacy records. Poor adherence was associated with being divorced, poorer, food insecure, and less educated. Longer travel time to clinic, concealing one's human immunodeficiency virus (HIV) status, and experiencing side effects predicted poor adherence. Over a third of the patients had cognitive impairment and poorer cognitive function was also associated with poor adherence. During follow-up (mean 275 days), 20% died—usually within 90 days of starting ART. Neuropsychiatric symptoms, advanced HIV, peripheral neuropathy symptoms, food insecurity, and poverty were associated with death. Neuropsychiatric symptoms, advanced HIV, and poverty remained significant independent predictors of death in a multivariate model adjusting for other significant factors. Social, economic, cognitive, and psychiatric problems impact adherence and survival for people receiving ART in rural Zambia.
Url:
DOI: 10.4269/ajtmh.2011.11-0187
PubMed: 21976587
PubMed Central: 3183792
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Byers</name></author><author><name sortKey="Bradbury, Richard" sort="Bradbury, Richard" uniqKey="Bradbury R" first="Richard" last="Bradbury">Richard Bradbury</name></author><author><name sortKey="Mang Ombe, Charles" sort="Mang Ombe, Charles" uniqKey="Mang Ombe C" first="Charles" last="Mang'Ombe">Charles Mang'Ombe</name></author><author><name sortKey="Organek, Natalie" sort="Organek, Natalie" uniqKey="Organek N" first="Natalie" last="Organek">Natalie Organek</name></author><author><name sortKey="Kaile, Trevor" sort="Kaile, Trevor" uniqKey="Kaile T" first="Trevor" last="Kaile">Trevor Kaile</name></author><author><name sortKey="Sinyama, Alex M" sort="Sinyama, Alex M" uniqKey="Sinyama A" first="Alex M." last="Sinyama">Alex M. Sinyama</name></author><author><name sortKey="Sinyangwe, Sylvester S" sort="Sinyangwe, Sylvester S" uniqKey="Sinyangwe S" first="Sylvester S." last="Sinyangwe">Sylvester S. Sinyangwe</name></author><author><name sortKey="Malama, Kennedy" sort="Malama, Kennedy" uniqKey="Malama K" first="Kennedy" last="Malama">Kennedy Malama</name></author><author><name sortKey="Malama, Costantine" sort="Malama, Costantine" uniqKey="Malama C" first="Costantine" last="Malama">Costantine Malama</name></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">21976587</idno><idno type="pmc">3183792</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3183792</idno><idno type="RBID">PMC:3183792</idno><idno type="doi">10.4269/ajtmh.2011.11-0187</idno><date when="2011">2011</date><idno type="wicri:Area/Pmc/Corpus">001618</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">001618</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Neuropsychiatric and Socioeconomic Status Impact Antiretroviral Adherence and Mortality in Rural Zambia</title><author><name sortKey="Birbeck, Gretchen L" sort="Birbeck, Gretchen L" uniqKey="Birbeck G" first="Gretchen L." last="Birbeck">Gretchen L. Birbeck</name></author><author><name sortKey="Kvalsund, Michelle P" sort="Kvalsund, Michelle P" uniqKey="Kvalsund M" first="Michelle P." last="Kvalsund">Michelle P. Kvalsund</name></author><author><name sortKey="Byers, Peter A" sort="Byers, Peter A" uniqKey="Byers P" first="Peter A." last="Byers">Peter A. Byers</name></author><author><name sortKey="Bradbury, Richard" sort="Bradbury, Richard" uniqKey="Bradbury R" first="Richard" last="Bradbury">Richard Bradbury</name></author><author><name sortKey="Mang Ombe, Charles" sort="Mang Ombe, Charles" uniqKey="Mang Ombe C" first="Charles" last="Mang'Ombe">Charles Mang'Ombe</name></author><author><name sortKey="Organek, Natalie" sort="Organek, Natalie" uniqKey="Organek N" first="Natalie" last="Organek">Natalie Organek</name></author><author><name sortKey="Kaile, Trevor" sort="Kaile, Trevor" uniqKey="Kaile T" first="Trevor" last="Kaile">Trevor Kaile</name></author><author><name sortKey="Sinyama, Alex M" sort="Sinyama, Alex M" uniqKey="Sinyama A" first="Alex M." last="Sinyama">Alex M. Sinyama</name></author><author><name sortKey="Sinyangwe, Sylvester S" sort="Sinyangwe, Sylvester S" uniqKey="Sinyangwe S" first="Sylvester S." last="Sinyangwe">Sylvester S. Sinyangwe</name></author><author><name sortKey="Malama, Kennedy" sort="Malama, Kennedy" uniqKey="Malama K" first="Kennedy" last="Malama">Kennedy Malama</name></author><author><name sortKey="Malama, Costantine" sort="Malama, Costantine" uniqKey="Malama C" first="Costantine" last="Malama">Costantine Malama</name></author></analytic><series><title level="j">The American Journal of Tropical Medicine and Hygiene</title><idno type="ISSN">0002-9637</idno><idno type="eISSN">1476-1645</idno><imprint><date when="2011">2011</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>We conducted a prospective cohort study of 496 adults starting antiretroviral treatment (ART) to determine the impact of neuropsychiatric symptoms and socioeconomic status on adherence and mortality. Almost 60% had good adherence based upon pharmacy records. Poor adherence was associated with being divorced, poorer, food insecure, and less educated. Longer travel time to clinic, concealing one's human immunodeficiency virus (HIV) status, and experiencing side effects predicted poor adherence. Over a third of the patients had cognitive impairment and poorer cognitive function was also associated with poor adherence. During follow-up (mean 275 days), 20% died—usually within 90 days of starting ART. Neuropsychiatric symptoms, advanced HIV, peripheral neuropathy symptoms, food insecurity, and poverty were associated with death. Neuropsychiatric symptoms, advanced HIV, and poverty remained significant independent predictors of death in a multivariate model adjusting for other significant factors. Social, economic, cognitive, and psychiatric problems impact adherence and survival for people receiving ART in rural Zambia.</p></div></front></TEI><pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Am J Trop Med Hyg</journal-id><journal-id journal-id-type="publisher-id">tpmd</journal-id><journal-title-group><journal-title>The American Journal of Tropical Medicine and Hygiene</journal-title></journal-title-group><issn pub-type="ppub">0002-9637</issn><issn pub-type="epub">1476-1645</issn><publisher><publisher-name>The American Society of Tropical Medicine and Hygiene</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">21976587</article-id><article-id pub-id-type="pmc">3183792</article-id><article-id pub-id-type="doi">10.4269/ajtmh.2011.11-0187</article-id><article-categories><subj-group subj-group-type="heading"><subject>Articles</subject></subj-group></article-categories><title-group><article-title>Neuropsychiatric and Socioeconomic Status Impact Antiretroviral Adherence and Mortality in Rural Zambia</article-title><alt-title alt-title-type="left-running-head">BIRBECK AND OTHERS</alt-title><alt-title alt-title-type="right-running-head">ART ADHERENCE AND MORTALITY</alt-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Birbeck</surname><given-names>Gretchen L.</given-names></name><xref ref-type="corresp" rid="COR1">*</xref></contrib><contrib contrib-type="author"><name><surname>Kvalsund</surname><given-names>Michelle P.</given-names></name></contrib><contrib contrib-type="author"><name><surname>Byers</surname><given-names>Peter A.</given-names></name></contrib><contrib contrib-type="author"><name><surname>Bradbury</surname><given-names>Richard</given-names></name></contrib><contrib contrib-type="author"><name><surname>Mang'ombe</surname><given-names>Charles</given-names></name></contrib><contrib contrib-type="author"><name><surname>Organek</surname><given-names>Natalie</given-names></name></contrib><contrib contrib-type="author"><name><surname>Kaile</surname><given-names>Trevor</given-names></name></contrib><contrib contrib-type="author"><name><surname>Sinyama</surname><given-names>Alex M.</given-names></name></contrib><contrib contrib-type="author"><name><surname>Sinyangwe</surname><given-names>Sylvester S.</given-names></name></contrib><contrib contrib-type="author"><name><surname>Malama</surname><given-names>Kennedy</given-names></name></contrib><contrib contrib-type="author"><name><surname>Malama</surname><given-names>Costantine</given-names></name></contrib></contrib-group><aff id="AFF1">Michigan State University, International Neurologic and Psychiatric Epidemiology Program, East Lansing, Michigan; Vanderbilt University, Department of Neurology, Nashville, Tennessee; Eastern Virginia Medical School, Department of Emergency Medicine, Norfolk, Virginia; Research and Development Unit, The Salvation Army, London, United Kingdom; Chikankata Hospital, Private Bag S2, Mazabuka, Zambia; Nakambala Clinic, Zambia Sugar PLC, Mazabuka, Zambia; University of Zambia, Department of Pediatrics and Child Health, Lusaka, Zambia; Provincial Health Office, Kabwe, Zambia; USAID/Zambia, Multisectoral office-HIV Prevention, Lusaka, Zambia</aff><author-notes><corresp id="COR1">*Address correspondence to Gretchen L. Birbeck, #324 West Fee Hall, East Lansing, MI 48824. E-mail: <email>birbeck@msu.edu</email></corresp></author-notes><pub-date pub-type="ppub"><day>01</day><month>10</month><year>2011</year></pub-date><volume>85</volume><issue>4</issue><fpage>782</fpage><lpage>789</lpage><history><date date-type="received"><day>29</day><month>3</month><year>2011</year></date><date date-type="accepted"><day>27</day><month>6</month><year>2011</year></date></history><permissions><copyright-statement>©The American Society of Tropical Medicine and Hygiene</copyright-statement><copyright-year>2011</copyright-year></permissions><abstract><p>We conducted a prospective cohort study of 496 adults starting antiretroviral treatment (ART) to determine the impact of neuropsychiatric symptoms and socioeconomic status on adherence and mortality. Almost 60% had good adherence based upon pharmacy records. Poor adherence was associated with being divorced, poorer, food insecure, and less educated. Longer travel time to clinic, concealing one's human immunodeficiency virus (HIV) status, and experiencing side effects predicted poor adherence. Over a third of the patients had cognitive impairment and poorer cognitive function was also associated with poor adherence. During follow-up (mean 275 days), 20% died—usually within 90 days of starting ART. Neuropsychiatric symptoms, advanced HIV, peripheral neuropathy symptoms, food insecurity, and poverty were associated with death. Neuropsychiatric symptoms, advanced HIV, and poverty remained significant independent predictors of death in a multivariate model adjusting for other significant factors. Social, economic, cognitive, and psychiatric problems impact adherence and survival for people receiving ART in rural Zambia.</p></abstract></article-meta><notes notes-type="disclaimer"><p>Disclaimer: The authors have no conflicts of interest.</p><p>Note: Supplemental appendix is available at <ext-link ext-link-type="uri" xlink:href="www.ajtmh.org">www.ajtmh.org</ext-link>.</p></notes></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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