Density of Healthcare Providers and Patient Outcomes: Evidence from a Nationally Representative Multi-Site HIV Treatment Program in Uganda
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Auteurs : Celestin Bakanda [Ouganda] ; Josephine Birungi [Ouganda] ; Robert Mwesigwa [Ouganda] ; Wendy Zhang [Canada] ; Amy Hagopian [Afrique du Sud] ; Nathan Ford [États-Unis] ; Edward J. Mills [Canada]Source :
- PLoS ONE [ 1932-6203 ] ; 2011.
Abstract
We examined the association between density of healthcare providers and patient outcomes using a large nationally representative cohort of patients receiving combination antiretroviral therapy (cART) in Uganda.
We obtained data from The AIDS Support Organization (TASO) in Uganda. Patients 18 years of age and older who initiated cART at TASO between 2004 and 2008 contributed to this analysis. The number of healthcare providers per 100 patients, the number of patients lost to follow-up per 100 person years and number of deaths per 100 person years were calculated. Spearman correlation was used to identify associations between patient loss to follow-up and mortality with the healthcare provider-patient ratios.
We found no significant associations between the number of patients lost to follow-up and physicians (
Patient outcomes, as measured by loss to follow-up and mortality, were not significantly associated with the number of doctors, nurses, clinical officers, field officers, or healthcare providers overall. This may suggest that that other factors, such as the presence of volunteer patient supporters or broader political or socioeconomic influences, may be more closely associated with outcomes of care among patients on cART in Uganda.
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DOI: 10.1371/journal.pone.0016279
PubMed: 21264224
PubMed Central: 3022029
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Density of Healthcare Providers and Patient Outcomes: Evidence from a Nationally Representative Multi-Site HIV Treatment Program in Uganda</title><author><name sortKey="Bakanda, Celestin" sort="Bakanda, Celestin" uniqKey="Bakanda C" first="Celestin" last="Bakanda">Celestin Bakanda</name><affiliation wicri:level="1"><nlm:aff id="aff1"><addr-line>The AIDS Support Organization, Headquarters, Kampala, Uganda</addr-line></nlm:aff><country xml:lang="fr">Ouganda</country><wicri:regionArea>The AIDS Support Organization, Headquarters, Kampala</wicri:regionArea></affiliation></author><author><name sortKey="Birungi, Josephine" sort="Birungi, Josephine" uniqKey="Birungi J" first="Josephine" last="Birungi">Josephine Birungi</name><affiliation wicri:level="1"><nlm:aff id="aff1"><addr-line>The AIDS Support Organization, Headquarters, Kampala, Uganda</addr-line></nlm:aff><country xml:lang="fr">Ouganda</country><wicri:regionArea>The AIDS Support Organization, Headquarters, Kampala</wicri:regionArea></affiliation></author><author><name sortKey="Mwesigwa, Robert" sort="Mwesigwa, Robert" uniqKey="Mwesigwa R" first="Robert" last="Mwesigwa">Robert Mwesigwa</name><affiliation wicri:level="1"><nlm:aff id="aff1"><addr-line>The AIDS Support Organization, Headquarters, Kampala, Uganda</addr-line></nlm:aff><country xml:lang="fr">Ouganda</country><wicri:regionArea>The AIDS Support Organization, Headquarters, Kampala</wicri:regionArea></affiliation></author><author><name sortKey="Zhang, Wendy" sort="Zhang, Wendy" uniqKey="Zhang W" first="Wendy" last="Zhang">Wendy Zhang</name><affiliation wicri:level="1"><nlm:aff id="aff2"><addr-line>British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada</addr-line></nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>British Columbia Centre for Excellence in HIV/AIDS, Vancouver</wicri:regionArea></affiliation></author><author><name sortKey="Hagopian, Amy" sort="Hagopian, Amy" uniqKey="Hagopian A" first="Amy" last="Hagopian">Amy Hagopian</name><affiliation wicri:level="1"><nlm:aff id="aff3"><addr-line>Division of Infectious Diseases, University of Cape Town, Cape Town, South Africa</addr-line></nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>Division of Infectious Diseases, University of Cape Town, Cape Town</wicri:regionArea></affiliation></author><author><name sortKey="Ford, Nathan" sort="Ford, Nathan" uniqKey="Ford N" first="Nathan" last="Ford">Nathan Ford</name><affiliation wicri:level="1"><nlm:aff id="aff4"><addr-line>Health Alliance International, School of Public Health, University of Washington, Seattle, Washington, United States of America</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Health Alliance International, School of Public Health, University of Washington, Seattle, Washington</wicri:regionArea></affiliation></author><author><name sortKey="Mills, Edward J" sort="Mills, Edward J" uniqKey="Mills E" first="Edward J." last="Mills">Edward J. Mills</name><affiliation wicri:level="1"><nlm:aff id="aff5"><addr-line>Faculty of Health Sciences, University of Ottawa, Ottawa, Canada</addr-line></nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Faculty of Health Sciences, University of Ottawa, Ottawa</wicri:regionArea></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">21264224</idno><idno type="pmc">3022029</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3022029</idno><idno type="RBID">PMC:3022029</idno><idno type="doi">10.1371/journal.pone.0016279</idno><date when="2011">2011</date><idno type="wicri:Area/Pmc/Corpus">002B49</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">002B49</idno><idno type="wicri:Area/Pmc/Curation">002B48</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">002B48</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Density of Healthcare Providers and Patient Outcomes: Evidence from a Nationally Representative Multi-Site HIV Treatment Program in Uganda</title><author><name sortKey="Bakanda, Celestin" sort="Bakanda, Celestin" uniqKey="Bakanda C" first="Celestin" last="Bakanda">Celestin Bakanda</name><affiliation wicri:level="1"><nlm:aff id="aff1"><addr-line>The AIDS Support Organization, Headquarters, Kampala, Uganda</addr-line></nlm:aff><country xml:lang="fr">Ouganda</country><wicri:regionArea>The AIDS Support Organization, Headquarters, Kampala</wicri:regionArea></affiliation></author><author><name sortKey="Birungi, Josephine" sort="Birungi, Josephine" uniqKey="Birungi J" first="Josephine" last="Birungi">Josephine Birungi</name><affiliation wicri:level="1"><nlm:aff id="aff1"><addr-line>The AIDS Support Organization, Headquarters, Kampala, Uganda</addr-line></nlm:aff><country xml:lang="fr">Ouganda</country><wicri:regionArea>The AIDS Support Organization, Headquarters, Kampala</wicri:regionArea></affiliation></author><author><name sortKey="Mwesigwa, Robert" sort="Mwesigwa, Robert" uniqKey="Mwesigwa R" first="Robert" last="Mwesigwa">Robert Mwesigwa</name><affiliation wicri:level="1"><nlm:aff id="aff1"><addr-line>The AIDS Support Organization, Headquarters, Kampala, Uganda</addr-line></nlm:aff><country xml:lang="fr">Ouganda</country><wicri:regionArea>The AIDS Support Organization, Headquarters, Kampala</wicri:regionArea></affiliation></author><author><name sortKey="Zhang, Wendy" sort="Zhang, Wendy" uniqKey="Zhang W" first="Wendy" last="Zhang">Wendy Zhang</name><affiliation wicri:level="1"><nlm:aff id="aff2"><addr-line>British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada</addr-line></nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>British Columbia Centre for Excellence in HIV/AIDS, Vancouver</wicri:regionArea></affiliation></author><author><name sortKey="Hagopian, Amy" sort="Hagopian, Amy" uniqKey="Hagopian A" first="Amy" last="Hagopian">Amy Hagopian</name><affiliation wicri:level="1"><nlm:aff id="aff3"><addr-line>Division of Infectious Diseases, University of Cape Town, Cape Town, South Africa</addr-line></nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>Division of Infectious Diseases, University of Cape Town, Cape Town</wicri:regionArea></affiliation></author><author><name sortKey="Ford, Nathan" sort="Ford, Nathan" uniqKey="Ford N" first="Nathan" last="Ford">Nathan Ford</name><affiliation wicri:level="1"><nlm:aff id="aff4"><addr-line>Health Alliance International, School of Public Health, University of Washington, Seattle, Washington, United States of America</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Health Alliance International, School of Public Health, University of Washington, Seattle, Washington</wicri:regionArea></affiliation></author><author><name sortKey="Mills, Edward J" sort="Mills, Edward J" uniqKey="Mills E" first="Edward J." last="Mills">Edward J. Mills</name><affiliation wicri:level="1"><nlm:aff id="aff5"><addr-line>Faculty of Health Sciences, University of Ottawa, Ottawa, Canada</addr-line></nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Faculty of Health Sciences, University of Ottawa, Ottawa</wicri:regionArea></affiliation></author></analytic><series><title level="j">PLoS ONE</title><idno type="eISSN">1932-6203</idno><imprint><date when="2011">2011</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Objective</title><p>We examined the association between density of healthcare providers and patient outcomes using a large nationally representative cohort of patients receiving combination antiretroviral therapy (cART) in Uganda.</p></sec><sec><title>Design</title><p>We obtained data from The AIDS Support Organization (TASO) in Uganda. Patients 18 years of age and older who initiated cART at TASO between 2004 and 2008 contributed to this analysis. The number of healthcare providers per 100 patients, the number of patients lost to follow-up per 100 person years and number of deaths per 100 person years were calculated. Spearman correlation was used to identify associations between patient loss to follow-up and mortality with the healthcare provider-patient ratios.</p></sec><sec><title>Results</title><p>We found no significant associations between the number of patients lost to follow-up and physicians (<italic>p</italic> = 0.45), nurses (<italic>p</italic> = 0.93), clinical officers (<italic>p</italic> = 0.80), field officers (<italic>p</italic> = 0.56), and healthcare providers overall (<italic>p</italic> = 0.83). Similarly, no significant associations were observed between mortality and physicians (<italic>p</italic> = 0.65), nurses (<italic>p</italic> = 0.49), clinical officers (<italic>p</italic> = 0.73), field officers (<italic>p</italic> = 0.78), and healthcare providers overall (<italic>p</italic> = 0.73).</p></sec><sec><title>Conclusions</title><p>Patient outcomes, as measured by loss to follow-up and mortality, were not significantly associated with the number of doctors, nurses, clinical officers, field officers, or healthcare providers overall. This may suggest that that other factors, such as the presence of volunteer patient supporters or broader political or socioeconomic influences, may be more closely associated with outcomes of care among patients on cART in Uganda.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Kober, K" uniqKey="Kober K">K Kober</name></author><author><name sortKey="Van Damme, W" uniqKey="Van Damme W">W Van Damme</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Barnighausen, T" uniqKey="Barnighausen T">T Barnighausen</name></author><author><name sortKey="Bloom, De" uniqKey="Bloom D">DE Bloom</name></author><author><name sortKey="Humair, S" uniqKey="Humair S">S Humair</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Chen, L" uniqKey="Chen L">L Chen</name></author><author><name sortKey="Evans, T" uniqKey="Evans T">T Evans</name></author><author><name sortKey="Anand, S" uniqKey="Anand S">S Anand</name></author><author><name sortKey="Boufford, Ji" uniqKey="Boufford J">JI Boufford</name></author><author><name sortKey="Brown, H" uniqKey="Brown H">H Brown</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Mills, Ej" uniqKey="Mills E">EJ Mills</name></author><author><name sortKey="Nachega, Jb" uniqKey="Nachega J">JB Nachega</name></author><author><name sortKey="Bangsberg, Dr" uniqKey="Bangsberg D">DR Bangsberg</name></author><author><name sortKey="Singh, S" uniqKey="Singh S">S Singh</name></author><author><name sortKey="Rachlis, B" uniqKey="Rachlis B">B Rachlis</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Paterson, Dl" uniqKey="Paterson D">DL Paterson</name></author><author><name sortKey="Swindells, S" uniqKey="Swindells S">S Swindells</name></author><author><name sortKey="Mohr, J" uniqKey="Mohr J">J 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uniqKey="Kiboneka A">A Kiboneka</name></author><author><name sortKey="Bnyatia, Rj" uniqKey="Bnyatia R">RJ BNyatia</name></author><author><name sortKey="Nabiryo, C" uniqKey="Nabiryo C">C Nabiryo</name></author><author><name sortKey="Anema, A" uniqKey="Anema A">A Anema</name></author><author><name sortKey="Cooper, Cl" uniqKey="Cooper C">CL Cooper</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Mills, Ej" uniqKey="Mills E">EJ Mills</name></author><author><name sortKey="Ford, N" uniqKey="Ford N">N Ford</name></author><author><name sortKey="Singh, S" uniqKey="Singh S">S Singh</name></author><author><name sortKey="Eyawo, O" uniqKey="Eyawo O">O Eyawo</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="O Brien, Dp" uniqKey="O Brien D">DP O'Brien</name></author><author><name sortKey="Venis, S" uniqKey="Venis S">S Venis</name></author><author><name sortKey="Greig, J" uniqKey="Greig J">J Greig</name></author><author><name sortKey="Shanks, L" uniqKey="Shanks L">L Shanks</name></author><author><name sortKey="Ellman, T" uniqKey="Ellman T">T Ellman</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Parkhurst, Jo" uniqKey="Parkhurst J">JO Parkhurst</name></author><author><name sortKey="Lush, L" uniqKey="Lush L">L Lush</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Ferradini, L" uniqKey="Ferradini L">L Ferradini</name></author><author><name sortKey="Jeannin, A" uniqKey="Jeannin A">A Jeannin</name></author><author><name sortKey="Pinoges, L" uniqKey="Pinoges L">L Pinoges</name></author><author><name sortKey="Izopet, J" uniqKey="Izopet J">J Izopet</name></author><author><name sortKey="Odhiambo, D" uniqKey="Odhiambo D">D Odhiambo</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Marino, P" uniqKey="Marino P">P Marino</name></author><author><name sortKey="Simoni, Ja" uniqKey="Simoni J">JA Simoni</name></author><author><name sortKey="Silverstein, Lb" uniqKey="Silverstein L">LB Silverstein</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Knodel, J" uniqKey="Knodel J">J Knodel</name></author><author><name sortKey="Kespichayawattana, J" uniqKey="Kespichayawattana J">J Kespichayawattana</name></author><author><name sortKey="Saengtienchai, C" uniqKey="Saengtienchai C">C Saengtienchai</name></author><author><name sortKey="Wiwatwanich, S" uniqKey="Wiwatwanich S">S Wiwatwanich</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Boyarinova, G" uniqKey="Boyarinova G">G Boyarinova</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Rosen, S" uniqKey="Rosen S">S Rosen</name></author><author><name sortKey="Fox, Mp" uniqKey="Fox M">MP Fox</name></author><author><name sortKey="Gill, Cj" uniqKey="Gill C">CJ Gill</name></author></analytic></biblStruct></listBibl></div1></back></TEI><pmc article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">PLoS One</journal-id><journal-id journal-id-type="publisher-id">plos</journal-id><journal-id journal-id-type="pmc">plosone</journal-id><journal-title-group><journal-title>PLoS ONE</journal-title></journal-title-group><issn pub-type="epub">1932-6203</issn><publisher><publisher-name>Public Library of Science</publisher-name><publisher-loc>San Francisco, USA</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">21264224</article-id><article-id pub-id-type="pmc">3022029</article-id><article-id pub-id-type="publisher-id">PONE-D-10-02618</article-id><article-id pub-id-type="doi">10.1371/journal.pone.0016279</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="Discipline-v2"><subject>Biology</subject><subj-group><subject>Microbiology</subject><subj-group><subject>Virology</subject><subj-group><subject>Antivirals</subject></subj-group></subj-group></subj-group></subj-group><subj-group subj-group-type="Discipline-v2"><subject>Medicine</subject><subj-group><subject>Clinical Research Design</subject><subj-group><subject>Longitudinal Studies</subject></subj-group></subj-group><subj-group><subject>Epidemiology</subject><subj-group><subject>Infectious Disease Epidemiology</subject></subj-group></subj-group><subj-group><subject>Global Health</subject></subj-group><subj-group><subject>Infectious Diseases</subject><subj-group><subject>Viral Diseases</subject><subj-group><subject>HIV</subject><subj-group><subject>HIV diagnosis and management</subject></subj-group></subj-group></subj-group></subj-group><subj-group><subject>Non-Clinical Medicine</subject><subj-group><subject>Health Care Policy</subject><subj-group><subject>Quality of Care</subject></subj-group></subj-group><subj-group><subject>Health Care Providers</subject><subject>Health Care Quality</subject><subject>Health Services Research</subject></subj-group></subj-group></subj-group></article-categories><title-group><article-title>Density of Healthcare Providers and Patient Outcomes: Evidence from a Nationally Representative Multi-Site HIV Treatment Program in Uganda</article-title><alt-title alt-title-type="running-head">Healthcare Providers and Patient Outcomes</alt-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Bakanda</surname><given-names>Celestin</given-names></name><xref ref-type="aff" rid="aff1"><sup>1</sup></xref></contrib><contrib contrib-type="author"><name><surname>Birungi</surname><given-names>Josephine</given-names></name><xref ref-type="aff" rid="aff1"><sup>1</sup></xref></contrib><contrib contrib-type="author"><name><surname>Mwesigwa</surname><given-names>Robert</given-names></name><xref ref-type="aff" rid="aff1"><sup>1</sup></xref></contrib><contrib contrib-type="author"><name><surname>Zhang</surname><given-names>Wendy</given-names></name><xref ref-type="aff" rid="aff2"><sup>2</sup></xref></contrib><contrib contrib-type="author"><name><surname>Hagopian</surname><given-names>Amy</given-names></name><xref ref-type="aff" rid="aff3"><sup>3</sup></xref></contrib><contrib contrib-type="author"><name><surname>Ford</surname><given-names>Nathan</given-names></name><xref ref-type="aff" rid="aff4"><sup>4</sup></xref></contrib><contrib contrib-type="author"><name><surname>Mills</surname><given-names>Edward J.</given-names></name><xref ref-type="aff" rid="aff5"><sup>5</sup></xref><xref ref-type="corresp" rid="cor1"><sup>*</sup></xref></contrib></contrib-group><aff id="aff1"><label>1</label><addr-line>The AIDS Support Organization, Headquarters, Kampala, Uganda</addr-line></aff><aff id="aff2"><label>2</label><addr-line>British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada</addr-line></aff><aff id="aff3"><label>3</label><addr-line>Division of Infectious Diseases, University of Cape Town, Cape Town, South Africa</addr-line></aff><aff id="aff4"><label>4</label><addr-line>Health Alliance International, School of Public Health, University of Washington, Seattle, Washington, United States of America</addr-line></aff><aff id="aff5"><label>5</label><addr-line>Faculty of Health Sciences, University of Ottawa, Ottawa, Canada</addr-line></aff><contrib-group><contrib contrib-type="editor"><name><surname>Myer</surname><given-names>Landon</given-names></name><role>Editor</role><xref ref-type="aff" rid="edit1"></xref></contrib></contrib-group><aff id="edit1">University of Cape Town, South Africa</aff><author-notes><corresp id="cor1">* E-mail: <email>edward.mills@uottawa.ca</email></corresp><fn fn-type="con"><p>Conceived and designed the experiments: JB CB RM WZ AH NF EJM. Performed the experiments: JB CB RM WZ AH NF EJM. Analyzed the data: WZ EJM. Wrote the paper: JB CB RM WZ AH NF EJM. Other: JB CB RM WZ AH NF EJM.</p></fn></author-notes><pub-date pub-type="collection"><year>2011</year></pub-date><pub-date pub-type="epub"><day>17</day><month>1</month><year>2011</year></pub-date><volume>6</volume><issue>1</issue><elocation-id>e16279</elocation-id><history><date date-type="received"><day>15</day><month>9</month><year>2010</year></date><date date-type="accepted"><day>9</day><month>12</month><year>2010</year></date></history><permissions><copyright-statement>Bakanda et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.</copyright-statement></permissions><abstract><sec><title>Objective</title><p>We examined the association between density of healthcare providers and patient outcomes using a large nationally representative cohort of patients receiving combination antiretroviral therapy (cART) in Uganda.</p></sec><sec><title>Design</title><p>We obtained data from The AIDS Support Organization (TASO) in Uganda. Patients 18 years of age and older who initiated cART at TASO between 2004 and 2008 contributed to this analysis. The number of healthcare providers per 100 patients, the number of patients lost to follow-up per 100 person years and number of deaths per 100 person years were calculated. Spearman correlation was used to identify associations between patient loss to follow-up and mortality with the healthcare provider-patient ratios.</p></sec><sec><title>Results</title><p>We found no significant associations between the number of patients lost to follow-up and physicians (<italic>p</italic> = 0.45), nurses (<italic>p</italic> = 0.93), clinical officers (<italic>p</italic> = 0.80), field officers (<italic>p</italic> = 0.56), and healthcare providers overall (<italic>p</italic> = 0.83). Similarly, no significant associations were observed between mortality and physicians (<italic>p</italic> = 0.65), nurses (<italic>p</italic> = 0.49), clinical officers (<italic>p</italic> = 0.73), field officers (<italic>p</italic> = 0.78), and healthcare providers overall (<italic>p</italic> = 0.73).</p></sec><sec><title>Conclusions</title><p>Patient outcomes, as measured by loss to follow-up and mortality, were not significantly associated with the number of doctors, nurses, clinical officers, field officers, or healthcare providers overall. This may suggest that that other factors, such as the presence of volunteer patient supporters or broader political or socioeconomic influences, may be more closely associated with outcomes of care among patients on cART in Uganda.</p></sec></abstract><counts><page-count count="6"></page-count></counts></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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