Evaluation of Three Sampling Methods to Monitor Outcomes of Antiretroviral Treatment Programmes in Low- and Middle-Income Countries.

Hdl Handle:
http://hdl.handle.net/10144/117126
Title:
Evaluation of Three Sampling Methods to Monitor Outcomes of Antiretroviral Treatment Programmes in Low- and Middle-Income Countries.
Authors:
Tassie, Jean-Michel; Malateste, Karen; Pujades-Rodríguez, Mar; Poulet, Elisabeth; Bennett, Diane; Harries, Anthony; Mahy, Mary; Schechter, Mauro; Souteyrand, Yves; Dabis, François
Journal:
PloS One
Abstract:
BACKGROUND: Retention of patients on antiretroviral therapy (ART) over time is a proxy for quality of care and an outcome indicator to monitor ART programs. Using existing databases (Antiretroviral in Lower Income Countries of the International Databases to Evaluate AIDS and Médecins Sans Frontières), we evaluated three sampling approaches to simplify the generation of outcome indicators. METHODS AND FINDINGS: We used individual patient data from 27 ART sites and included 27,201 ART-naive adults (≥15 years) who initiated ART in 2005. For each site, we generated two outcome indicators at 12 months, retention on ART and proportion of patients lost to follow-up (LFU), first using all patient data and then within a smaller group of patients selected using three sampling methods (random, systematic and consecutive sampling). For each method and each site, 500 samples were generated, and the average result was compared with the unsampled value. The 95% sampling distribution (SD) was expressed as the 2.5(th) and 97.5(th) percentile values from the 500 samples. Overall, retention on ART was 76.5% (range 58.9-88.6) and the proportion of patients LFU, 13.5% (range 0.8-31.9). Estimates of retention from sampling (n = 5696) were 76.5% (SD 75.4-77.7) for random, 76.5% (75.3-77.5) for systematic and 76.0% (74.1-78.2) for the consecutive method. Estimates for the proportion of patients LFU were 13.5% (12.6-14.5), 13.5% (12.6-14.3) and 14.0% (12.5-15.5), respectively. With consecutive sampling, 50% of sites had SD within ±5% of the unsampled site value. CONCLUSIONS: Our results suggest that random, systematic or consecutive sampling methods are feasible for monitoring ART indicators at national level. However, sampling may not produce precise estimates in some sites.
Affiliation:
Department of HIV/AIDS, World Health Organisation, Geneva, Switzerland.
Issue Date:
10-Nov-2010
URI:
http://hdl.handle.net/10144/117126
DOI:
10.1371/journal.pone.0013899
PubMed ID:
21085709
Language:
en
ISSN:
1932-6203
Appears in Collections:
Research Methods

Full metadata record

DC FieldValue Language
dc.contributor.authorTassie, Jean-Michelen
dc.contributor.authorMalateste, Karenen
dc.contributor.authorPujades-Rodríguez, Maren
dc.contributor.authorPoulet, Elisabethen
dc.contributor.authorBennett, Dianeen
dc.contributor.authorHarries, Anthonyen
dc.contributor.authorMahy, Maryen
dc.contributor.authorSchechter, Mauroen
dc.contributor.authorSouteyrand, Yvesen
dc.contributor.authorDabis, Françoisen
dc.date.accessioned2010-12-03T14:08:53Z-
dc.date.available2010-12-03T14:08:53Z-
dc.date.issued2010-11-10-
dc.identifier.citationEvaluation of Three Sampling Methods to Monitor Outcomes of Antiretroviral Treatment Programmes in Low- and Middle-Income Countries. 2010, 5 (11):e13899notPLoS Oneen
dc.identifier.issn1932-6203-
dc.identifier.pmid21085709-
dc.identifier.doi10.1371/journal.pone.0013899-
dc.identifier.urihttp://hdl.handle.net/10144/117126-
dc.description.abstractBACKGROUND: Retention of patients on antiretroviral therapy (ART) over time is a proxy for quality of care and an outcome indicator to monitor ART programs. Using existing databases (Antiretroviral in Lower Income Countries of the International Databases to Evaluate AIDS and Médecins Sans Frontières), we evaluated three sampling approaches to simplify the generation of outcome indicators. METHODS AND FINDINGS: We used individual patient data from 27 ART sites and included 27,201 ART-naive adults (≥15 years) who initiated ART in 2005. For each site, we generated two outcome indicators at 12 months, retention on ART and proportion of patients lost to follow-up (LFU), first using all patient data and then within a smaller group of patients selected using three sampling methods (random, systematic and consecutive sampling). For each method and each site, 500 samples were generated, and the average result was compared with the unsampled value. The 95% sampling distribution (SD) was expressed as the 2.5(th) and 97.5(th) percentile values from the 500 samples. Overall, retention on ART was 76.5% (range 58.9-88.6) and the proportion of patients LFU, 13.5% (range 0.8-31.9). Estimates of retention from sampling (n = 5696) were 76.5% (SD 75.4-77.7) for random, 76.5% (75.3-77.5) for systematic and 76.0% (74.1-78.2) for the consecutive method. Estimates for the proportion of patients LFU were 13.5% (12.6-14.5), 13.5% (12.6-14.3) and 14.0% (12.5-15.5), respectively. With consecutive sampling, 50% of sites had SD within ±5% of the unsampled site value. CONCLUSIONS: Our results suggest that random, systematic or consecutive sampling methods are feasible for monitoring ART indicators at national level. However, sampling may not produce precise estimates in some sites.en
dc.languageENG-
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.titleEvaluation of Three Sampling Methods to Monitor Outcomes of Antiretroviral Treatment Programmes in Low- and Middle-Income Countries.en
dc.contributor.departmentDepartment of HIV/AIDS, World Health Organisation, Geneva, Switzerland.en
dc.identifier.journalPloS Oneen
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