Trends in loss to follow-up among migrant workers on antiretroviral therapy in a community cohort in Lesotho.

Hdl Handle:
http://hdl.handle.net/10144/116358
Title:
Trends in loss to follow-up among migrant workers on antiretroviral therapy in a community cohort in Lesotho.
Authors:
Bygrave, Helen; Kranzer, Katharina; Hilderbrand, Katherine; Whittall, Jonathan; Jouquet, Guillaume; Goemaere, Eric; Vlahakis, Nathalie; Triviño, Laura; Makakole, Lipontso; Ford, Nathan
Journal:
PloS One
Abstract:
BACKGROUND: The provision of antiretroviral therapy (ART) to migrant populations raises particular challenges with respect to ensuring adequate treatment support, adherence, and retention in care. We assessed rates of loss to follow-up for migrant workers compared with non-migrant workers in a routine treatment programme in Morjia, Lesotho. DESIGN: All adult patients (≥18 years) initiating ART between January 1, 2008, and December 31, 2008, and followed up until the end of 2009, were included in the study. We described rates of loss to follow-up according to migrant status by Kaplan-Meier estimates, and used Poisson regression to model associations between migrant status and loss to follow-up controlling for potential confounders identified a priori. RESULTS: Our cohort comprised 1185 people, among whom 12% (148) were migrant workers. Among the migrant workers, median age was 36.1 (29.6-45.9) and the majority (55%) were male. We found no statistically significant differences between baseline characteristics and migrant status. Rates of lost to follow up were similar between migrants and non-migrants in the first 3 months but differences increased thereafter. Between 3 and 6 months after initiating antiretroviral therapy, migrants had a 2.78-fold increased rate of defaulting (95%CI 1.15-6.73); between 6 and 12 months the rate was 2.36 times greater (95%CI 1.18-4.73), whereas after 1 year the rate was 6.69 times greater (95%CI 3.18-14.09). CONCLUSIONS: Our study highlights the need for programme implementers to take into account the specific challenges that may influence continuity of antiretroviral treatment and care for migrant populations.
Affiliation:
Médecins Sans Frontières, Morija, Lesotho. helenbygrave@hotmail.com
Issue Date:
8-Oct-2010
URI:
http://hdl.handle.net/10144/116358
DOI:
10.1371/journal.pone.0013198
PubMed ID:
20976289
Language:
en
ISSN:
1932-6203
Appears in Collections:
HIV/AIDS

Full metadata record

DC FieldValue Language
dc.contributor.authorBygrave, Helenen
dc.contributor.authorKranzer, Katharinaen
dc.contributor.authorHilderbrand, Katherineen
dc.contributor.authorWhittall, Jonathanen
dc.contributor.authorJouquet, Guillaumeen
dc.contributor.authorGoemaere, Ericen
dc.contributor.authorVlahakis, Nathalieen
dc.contributor.authorTriviño, Lauraen
dc.contributor.authorMakakole, Lipontsoen
dc.contributor.authorFord, Nathanen
dc.date.accessioned2010-11-25T21:44:36Z-
dc.date.available2010-11-25T21:44:36Z-
dc.date.issued2010-10-08-
dc.identifier.citationTrends in loss to follow-up among migrant workers on antiretroviral therapy in a community cohort in Lesotho. 2010, 5 (10):e13198 PLoS ONEen
dc.identifier.issn1932-6203-
dc.identifier.pmid20976289-
dc.identifier.doi10.1371/journal.pone.0013198-
dc.identifier.urihttp://hdl.handle.net/10144/116358-
dc.description.abstractBACKGROUND: The provision of antiretroviral therapy (ART) to migrant populations raises particular challenges with respect to ensuring adequate treatment support, adherence, and retention in care. We assessed rates of loss to follow-up for migrant workers compared with non-migrant workers in a routine treatment programme in Morjia, Lesotho. DESIGN: All adult patients (≥18 years) initiating ART between January 1, 2008, and December 31, 2008, and followed up until the end of 2009, were included in the study. We described rates of loss to follow-up according to migrant status by Kaplan-Meier estimates, and used Poisson regression to model associations between migrant status and loss to follow-up controlling for potential confounders identified a priori. RESULTS: Our cohort comprised 1185 people, among whom 12% (148) were migrant workers. Among the migrant workers, median age was 36.1 (29.6-45.9) and the majority (55%) were male. We found no statistically significant differences between baseline characteristics and migrant status. Rates of lost to follow up were similar between migrants and non-migrants in the first 3 months but differences increased thereafter. Between 3 and 6 months after initiating antiretroviral therapy, migrants had a 2.78-fold increased rate of defaulting (95%CI 1.15-6.73); between 6 and 12 months the rate was 2.36 times greater (95%CI 1.18-4.73), whereas after 1 year the rate was 6.69 times greater (95%CI 3.18-14.09). CONCLUSIONS: Our study highlights the need for programme implementers to take into account the specific challenges that may influence continuity of antiretroviral treatment and care for migrant populations.en
dc.language.isoenen
dc.rightsPublished by Public Library of Science, [url]http://www.plosone.org/[/url] Archived on this site by Open Access permissionen
dc.titleTrends in loss to follow-up among migrant workers on antiretroviral therapy in a community cohort in Lesotho.en
dc.contributor.departmentMédecins Sans Frontières, Morija, Lesotho. helenbygrave@hotmail.comen
dc.identifier.journalPloS Oneen

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