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Title: Vital status of pre-ART and ART patients defaulting from care in rural Malawi
Authors: McGuire, Megan
Munyenyembe, Tamika
Szumilin, Elisabeth
Heinzelmann, Annette
Le Paih, Mickael
Bouithy, Nenette
Pujades-Rodríguez, Mar
Affiliation: Médecins Sans Frontières, Chiradzulu, Malawi; Médecins Sans Frontières, Paris, France; Epicentre, Paris, France
Citation: Trop Med Int Health 2010;15(Suppl 1):55-62
Journal: Tropical Medicine & International Health
Issue Date: 29-Apr-2010
URI: http://hdl.handle.net/10144/114130
DOI: 10.1111/j.1365-3156.2010.02504.x
PubMed ID: 20586961
Additional Links: http://onlinelibrary.wiley.com/doi/10.1111/j.1365-3156.2010.02504.x/abstract?systemMessage=Due+to+scheduled+maintenance+access+to+the+Wiley+Online+Library+may+be+disrupted+as+follows%3A+Saturday%2C+16+October+-+New+York+0700+EDT+to+0900+EDT%3B+London+1200+BST+to+1400+BST%3B+Singapore+1900+SGT+to+2100+SGT
Abstract: OBJECTIVES: To ascertain the outcome of pre-Antiretroviral therapy (ART) and ART patients defaulting from care and investigate reasons for defaulting. METHODS: Patients defaulting from HIV care in Chiradzulu between July 2004 and September 2007 were traced at last known home address. Deaths and moves were recorded, and patients found alive were interviewed. Defaulting was defined as missed last appointment by more than 1 month among patients of unknown vital status. RESULTS: A total of 1637 individuals were traced (54%-88% of eligible), 981 pre-ART and 656 ART patients. Of 694 pre-ART patients found, 49% had died (51% of adults and 38% of children), a median of 47 days after defaulting, and 14% had moved away. Of 451 ART patients found, 54% had died (54% of adults and 50% of children), a median of 52 days after defaulting, and 20% had moved away. Overall, 221 patients were interviewed (90% of those found alive), 42% had worked outside the district in the previous year; 49% of pre-ART and 19% of ART patients had not disclosed their HIV status to other household members. Main reasons for defaulting were stigma (43%), care dissatisfaction (34%), improved health (28%) and for ART discontinuation, poor understanding of disease or treatment (56%) and drug side effects (42%). CONCLUSION: This study in a rural African HIV programme reveals the dynamics related to health service access and use, and it provides information to correct programme mortality estimates for adults and children.
Type: Article
Language: en
MeSH: HIV/AIDS
ISSN: 1365-3156
Rights: Archived on this site with the kind permission of Wiley-Blackwell, http://www.blackwell-synergy.com/loi/tmi
Appears in topics: HIV/AIDS

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