SidaSubSaharaV1, Pmc, Corpus, bibRecord, 001904

Socioeconomic Support Reduces Nonretention in a Comprehensive, Community-Based Antiretroviral Therapy Program in Uganda

Identifieur interne : 001904 ( Pmc/Corpus ); précédent : 001903; suivant : 001905

Socioeconomic Support Reduces Nonretention in a Comprehensive, Community-Based Antiretroviral Therapy Program in Uganda

Auteurs : Stella Talisuna-Alamo ; Robert Colebunders ; Joseph Ouma ; Pamela Sunday ; Kenneth Ekoru ; Marie Laga ; Glenn Wagner ; Fred Wabwire-Mangen

Source :

Journal of acquired immune deficiency syndromes (1999) [ 1525-4135 ] ; 2012.

RBID : PMC:3887145

Abstract

Objectives

We evaluated the benefit of socioeconomic support (S-E support), comprising various financial and nonfinancial services that are available based on assessment of need, in reducing mortality and lost to follow-up (LTFU) at Reach Out Mbuya, a community-based, antiretroviral therapy program in Uganda.

Design

Retrospective observational cohort data from adult patients enrolled between May 31, 2001, and May 31, 2010, were examined.

Methods

Patients were categorized into none, 1, and 2 or more S-E support based on the number of different S-E support services they received. Using Cox proportional hazards regression, we modeled the association between S-E support and mortality or LTFU. Kaplan–Meier curves were fitted to examine retention functions stratified by S-E support.

Results

In total, 6654 patients were evaluated. After 10 years, 2700 (41%) were retained. Of the 3954 not retained, 2933 (74%) were LTFU and 1021 (26%) had died. After 1, 2, 5, and 10 years, the risks of LTFU or mortality in patients who received no S-E support were significantly higher than those who received some S-E support. In adjusted hazards ratios, patients who received no S-E support were 1.5-fold (1.39–1.64) and 6.7-fold (5.56–7.69) more likely to get LTFU compared with those who received 1 or ≥2 S-E support, respectively. Likewise, patients who received no S-E support were 1.5-fold (confidence interval: 1.16 to 1.89) and 4.3-fold (confidence interval: 2.94 to 6.25) more likely to die compared with those who received 1 or 2+ S-E support, respectively.

Conclusions

Provision of S-E support reduced LTFU and mortality, suggesting the value of incorporating such strategies for promoting continuity of care.

Url:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3887145

DOI: 10.1097/QAI.0b013e318246e2aa
PubMed: 22217680
PubMed Central: 3887145

Links to Exploration step

PMC:3887145

Le document en format XML

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<author><name sortKey="Talisuna Alamo, Stella" sort="Talisuna Alamo, Stella" uniqKey="Talisuna Alamo S" first="Stella" last="Talisuna-Alamo">Stella Talisuna-Alamo</name>
<affiliation><nlm:aff id="A1">Medical Department, Reach Out Mbuya HIV/AIDS Initiative, Kampala, Uganda</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Colebunders, Robert" sort="Colebunders, Robert" uniqKey="Colebunders R" first="Robert" last="Colebunders">Robert Colebunders</name>
<affiliation><nlm:aff id="A2">Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="A3">Epidemiology and Social Medicine, University of Antwerp, Antwerp, Belgium</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Ouma, Joseph" sort="Ouma, Joseph" uniqKey="Ouma J" first="Joseph" last="Ouma">Joseph Ouma</name>
<affiliation><nlm:aff id="A4">Department of Strategic Planning, Management Sciences for Health, Kampala, Uganda</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Sunday, Pamela" sort="Sunday, Pamela" uniqKey="Sunday P" first="Pamela" last="Sunday">Pamela Sunday</name>
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<author><name sortKey="Ekoru, Kenneth" sort="Ekoru, Kenneth" uniqKey="Ekoru K" first="Kenneth" last="Ekoru">Kenneth Ekoru</name>
<affiliation><nlm:aff>NONE</nlm:aff>
</affiliation>
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<author><name sortKey="Laga, Marie" sort="Laga, Marie" uniqKey="Laga M" first="Marie" last="Laga">Marie Laga</name>
<affiliation><nlm:aff id="A6">HIV Epidemiology and Control Unit, Institute of Tropical Medicine, Antwerp, Belgium</nlm:aff>
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<author><name sortKey="Wagner, Glenn" sort="Wagner, Glenn" uniqKey="Wagner G" first="Glenn" last="Wagner">Glenn Wagner</name>
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<author><name sortKey="Wabwire Mangen, Fred" sort="Wabwire Mangen, Fred" uniqKey="Wabwire Mangen F" first="Fred" last="Wabwire-Mangen">Fred Wabwire-Mangen</name>
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Socioeconomic Support Reduces Nonretention in a Comprehensive, Community-Based Antiretroviral Therapy Program in Uganda</title>
<author><name sortKey="Talisuna Alamo, Stella" sort="Talisuna Alamo, Stella" uniqKey="Talisuna Alamo S" first="Stella" last="Talisuna-Alamo">Stella Talisuna-Alamo</name>
<affiliation><nlm:aff id="A1">Medical Department, Reach Out Mbuya HIV/AIDS Initiative, Kampala, Uganda</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Colebunders, Robert" sort="Colebunders, Robert" uniqKey="Colebunders R" first="Robert" last="Colebunders">Robert Colebunders</name>
<affiliation><nlm:aff id="A2">Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="A3">Epidemiology and Social Medicine, University of Antwerp, Antwerp, Belgium</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Ouma, Joseph" sort="Ouma, Joseph" uniqKey="Ouma J" first="Joseph" last="Ouma">Joseph Ouma</name>
<affiliation><nlm:aff id="A4">Department of Strategic Planning, Management Sciences for Health, Kampala, Uganda</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Sunday, Pamela" sort="Sunday, Pamela" uniqKey="Sunday P" first="Pamela" last="Sunday">Pamela Sunday</name>
<affiliation><nlm:aff id="A1">Medical Department, Reach Out Mbuya HIV/AIDS Initiative, Kampala, Uganda</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Ekoru, Kenneth" sort="Ekoru, Kenneth" uniqKey="Ekoru K" first="Kenneth" last="Ekoru">Kenneth Ekoru</name>
<affiliation><nlm:aff>NONE</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Laga, Marie" sort="Laga, Marie" uniqKey="Laga M" first="Marie" last="Laga">Marie Laga</name>
<affiliation><nlm:aff id="A6">HIV Epidemiology and Control Unit, Institute of Tropical Medicine, Antwerp, Belgium</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Wagner, Glenn" sort="Wagner, Glenn" uniqKey="Wagner G" first="Glenn" last="Wagner">Glenn Wagner</name>
<affiliation><nlm:aff id="A7">Health Unit, RAND Corporation, Santa Monica, CA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Wabwire Mangen, Fred" sort="Wabwire Mangen, Fred" uniqKey="Wabwire Mangen F" first="Fred" last="Wabwire-Mangen">Fred Wabwire-Mangen</name>
<affiliation><nlm:aff id="A8">Department of Epidemiology and Biostatistics, Makerere University School of Public Health, Kampala, Uganda</nlm:aff>
</affiliation>
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<series><title level="j">Journal of acquired immune deficiency syndromes (1999)</title>
<idno type="ISSN">1525-4135</idno>
<idno type="eISSN">1944-7884</idno>
<imprint><date when="2012">2012</date>
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<front><div type="abstract" xml:lang="en"><sec id="S1"><title>Objectives</title>
<p id="P1">We evaluated the benefit of socioeconomic support (S-E support), comprising various financial and nonfinancial services that are available based on assessment of need, in reducing mortality and lost to follow-up (LTFU) at Reach Out Mbuya, a community-based, antiretroviral therapy program in Uganda.</p>
</sec>
<sec id="S2"><title>Design</title>
<p id="P2">Retrospective observational cohort data from adult patients enrolled between May 31, 2001, and May 31, 2010, were examined.</p>
</sec>
<sec id="S3"><title>Methods</title>
<p id="P3">Patients were categorized into none, 1, and 2 or more S-E support based on the number of different S-E support services they received. Using Cox proportional hazards regression, we modeled the association between S-E support and mortality or LTFU. Kaplan–Meier curves were fitted to examine retention functions stratified by S-E support.</p>
</sec>
<sec id="S4"><title>Results</title>
<p id="P4">In total, 6654 patients were evaluated. After 10 years, 2700 (41%) were retained. Of the 3954 not retained, 2933 (74%) were LTFU and 1021 (26%) had died. After 1, 2, 5, and 10 years, the risks of LTFU or mortality in patients who received no S-E support were significantly higher than those who received some S-E support. In adjusted hazards ratios, patients who received no S-E support were 1.5-fold (1.39–1.64) and 6.7-fold (5.56–7.69) more likely to get LTFU compared with those who received 1 or ≥2 S-E support, respectively. Likewise, patients who received no S-E support were 1.5-fold (confidence interval: 1.16 to 1.89) and 4.3-fold (confidence interval: 2.94 to 6.25) more likely to die compared with those who received 1 or 2+ S-E support, respectively.</p>
</sec>
<sec id="S5"><title>Conclusions</title>
<p id="P5">Provision of S-E support reduced LTFU and mortality, suggesting the value of incorporating such strategies for promoting continuity of care.</p>
</sec>
</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>
  <pmc-dir>properties manuscript</pmc-dir>
  <front><journal-meta><journal-id journal-id-type="nlm-journal-id">100892005</journal-id>
<journal-id journal-id-type="pubmed-jr-id">21821</journal-id>
<journal-id journal-id-type="nlm-ta">J Acquir Immune Defic Syndr</journal-id>
<journal-id journal-id-type="iso-abbrev">J. Acquir. Immune Defic. Syndr.</journal-id>
<journal-title-group><journal-title>Journal of acquired immune deficiency syndromes (1999)</journal-title>
</journal-title-group>
<issn pub-type="ppub">1525-4135</issn>
<issn pub-type="epub">1944-7884</issn>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">22217680</article-id>
<article-id pub-id-type="pmc">3887145</article-id>
<article-id pub-id-type="doi">10.1097/QAI.0b013e318246e2aa</article-id>
<article-id pub-id-type="manuscript">NIHMS536312</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Article</subject>
</subj-group>
</article-categories>
<title-group><article-title>Socioeconomic Support Reduces Nonretention in a Comprehensive, Community-Based Antiretroviral Therapy Program in Uganda</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Talisuna-Alamo</surname>
<given-names>Stella</given-names>
</name>
<degrees>MD, MDC</degrees>
<xref ref-type="aff" rid="A1">*</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Colebunders</surname>
<given-names>Robert</given-names>
</name>
<degrees>MD, PhD</degrees>
<xref ref-type="aff" rid="A2">†</xref>
<xref ref-type="aff" rid="A3">‡</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Ouma</surname>
<given-names>Joseph</given-names>
</name>
<degrees>BStat, MStat</degrees>
<xref ref-type="aff" rid="A4">§</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Sunday</surname>
<given-names>Pamela</given-names>
</name>
<degrees>BScQE</degrees>
<xref ref-type="aff" rid="A1">*</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Ekoru</surname>
<given-names>Kenneth</given-names>
</name>
<degrees>BStat, MStat</degrees>
<xref ref-type="aff" rid="A5">║</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Laga</surname>
<given-names>Marie</given-names>
</name>
<degrees>MD, PhD</degrees>
<xref ref-type="aff" rid="A6">¶</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Wagner</surname>
<given-names>Glenn</given-names>
</name>
<degrees>PhD</degrees>
<xref ref-type="aff" rid="A7">#</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Wabwire-Mangen</surname>
<given-names>Fred</given-names>
</name>
<degrees>MD, PhD</degrees>
<xref ref-type="aff" rid="A8">**</xref>
</contrib>
</contrib-group>
<aff id="A1"><label>*</label>
Medical Department, Reach Out Mbuya HIV/AIDS Initiative, Kampala, Uganda</aff>
<aff id="A2"><label>†</label>
Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium</aff>
<aff id="A3"><label>‡</label>
Epidemiology and Social Medicine, University of Antwerp, Antwerp, Belgium</aff>
<aff id="A4"><label>§</label>
Department of Strategic Planning, Management Sciences for Health, Kampala, Uganda</aff>
<aff id="A5"><label>‖</label>
Clinical Epidemiology Unit, Makerere University</aff>
<aff id="A6"><label>¶</label>
HIV Epidemiology and Control Unit, Institute of Tropical Medicine, Antwerp, Belgium</aff>
<aff id="A7"><label>#</label>
Health Unit, RAND Corporation, Santa Monica, CA</aff>
<aff id="A8"><label>**</label>
Department of Epidemiology and Biostatistics, Makerere University School of Public Health, Kampala, Uganda</aff>
<author-notes><corresp id="cor1">Correspondence to: Stella Talisuna-Alamo, MD, Reach Out Mbuya HIV/ AIDS Initiative, P.O. Box 7303 Kampala, Uganda (<email>stellaalamo@gmail.com</email>
)</corresp>
</author-notes>
<pub-date pub-type="nihms-submitted"><day>17</day>
<month>12</month>
<year>2013</year>
</pub-date>
<pub-date pub-type="ppub"><day>1</day>
<month>4</month>
<year>2012</year>
</pub-date>
<pub-date pub-type="pmc-release"><day>09</day>
<month>1</month>
<year>2014</year>
</pub-date>
<volume>59</volume>
<issue>4</issue>
<elocation-id>10.1097/QAI.0b013e318246e2aa</elocation-id>
<permissions><copyright-statement>Copyright © 2012 by Lippincott Williams & Wilkins</copyright-statement>
<copyright-year>2012</copyright-year>
</permissions>
<abstract><sec id="S1"><title>Objectives</title>
<p id="P1">We evaluated the benefit of socioeconomic support (S-E support), comprising various financial and nonfinancial services that are available based on assessment of need, in reducing mortality and lost to follow-up (LTFU) at Reach Out Mbuya, a community-based, antiretroviral therapy program in Uganda.</p>
</sec>
<sec id="S2"><title>Design</title>
<p id="P2">Retrospective observational cohort data from adult patients enrolled between May 31, 2001, and May 31, 2010, were examined.</p>
</sec>
<sec id="S3"><title>Methods</title>
<p id="P3">Patients were categorized into none, 1, and 2 or more S-E support based on the number of different S-E support services they received. Using Cox proportional hazards regression, we modeled the association between S-E support and mortality or LTFU. Kaplan–Meier curves were fitted to examine retention functions stratified by S-E support.</p>
</sec>
<sec id="S4"><title>Results</title>
<p id="P4">In total, 6654 patients were evaluated. After 10 years, 2700 (41%) were retained. Of the 3954 not retained, 2933 (74%) were LTFU and 1021 (26%) had died. After 1, 2, 5, and 10 years, the risks of LTFU or mortality in patients who received no S-E support were significantly higher than those who received some S-E support. In adjusted hazards ratios, patients who received no S-E support were 1.5-fold (1.39–1.64) and 6.7-fold (5.56–7.69) more likely to get LTFU compared with those who received 1 or ≥2 S-E support, respectively. Likewise, patients who received no S-E support were 1.5-fold (confidence interval: 1.16 to 1.89) and 4.3-fold (confidence interval: 2.94 to 6.25) more likely to die compared with those who received 1 or 2+ S-E support, respectively.</p>
</sec>
<sec id="S5"><title>Conclusions</title>
<p id="P5">Provision of S-E support reduced LTFU and mortality, suggesting the value of incorporating such strategies for promoting continuity of care.</p>
</sec>
</abstract>
<kwd-group><kwd>HIV</kwd>
<kwd>socioeconomic support</kwd>
<kwd>loss to follow-up</kwd>
<kwd>mortality</kwd>
<kwd>retained antiretroviral therapy</kwd>
<kwd>community-based care</kwd>
</kwd-group>
<funding-group><award-group><funding-source country="United States">National Institute of Child Health & Human Development : NICHD</funding-source>
<award-id>R24 HD056651 || HD</award-id>
</award-group>
</funding-group>
</article-meta>
</front>
</pmc>
</record>

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Le SIDA en Afrique subsaharienne (serveur d'exploration)

Socioeconomic Support Reduces Nonretention in a Comprehensive, Community-Based Antiretroviral Therapy Program in Uganda

Socioeconomic Support Reduces Nonretention in a Comprehensive, Community-Based Antiretroviral Therapy Program in Uganda

Source :

Abstract

Links to Exploration step

Le document en format XML

Pour manipuler ce document sous Unix (Dilib)

Pour mettre un lien sur cette page dans le réseau Wicri

Pour générer des pages wiki