Community support is associated with better antiretroviral treatment outcomes in a resource-limited rural district in Malawi.

Hdl Handle:
http://hdl.handle.net/10144/17244
Title:
Community support is associated with better antiretroviral treatment outcomes in a resource-limited rural district in Malawi.
Authors:
Zachariah, R; Teck, R; Buhendwa, L; Fitzgerald, M; Labana, S; Chinji, C; Humblet, P; Harries, A D
Journal:
Transactions of the Royal Society of Tropical Medicine and Hygiene
Abstract:
A study was carried in a rural district in Malawi among HIV-positive individuals placed on antiretroviral treatment (ART) in order to verify if community support influences ART outcomes. Standardized ART outcomes in areas of the district with and without community support were compared. Between April 2003 (when ART was started) and December 2004 a total of 1634 individuals had been placed on ART. Eight hundred and ninety-five (55%) individuals were offered community support, while 739 received no such support. For all patients placed on ART with and without community support, those who were alive and continuing ART were 96 and 76%, respectively (P<0.001); death was 3.5 and 15.5% (P<0.001); loss to follow-up was 0.1 and 5.2% (P<0.001); and stopped ART was 0.8 and 3.3% (P<0.001). The relative risks (with 95% CI) for alive and on ART [1.26 (1.21-1.32)], death [0.22 (0.15-0.33)], loss to follow-up [0.02 (0-0.12)] and stopped ART [0.23 (0.08-0.54)] were all significantly better in those offered community support (P<0.001). Community support is associated with a considerably lower death rate and better overall ART outcomes. The community might be an unrecognized and largely 'unexploited resource' that could play an important contributory role in countries desperately trying to scale up ART with limited resources.
Affiliation:
Médecins Sans Frontières, Medical Department (Operational Research), Brussels Operational Center, 68 Rue de Gasperich, L-1617, Luxembourg, Belgium. zachariah@internet.lu
Publisher:
Elsevier
Issue Date:
Jan-2007
URI:
http://hdl.handle.net/10144/17244
DOI:
10.1016/j.trstmh.2006.05.010
PubMed ID:
16962622
Additional Links:
http://www.sciencedirect.com/science/journal
Language:
en
ISSN:
0035-9203
Appears in Collections:
HIV/AIDS

Full metadata record

DC FieldValue Language
dc.contributor.authorZachariah, R-
dc.contributor.authorTeck, R-
dc.contributor.authorBuhendwa, L-
dc.contributor.authorFitzgerald, M-
dc.contributor.authorLabana, S-
dc.contributor.authorChinji, C-
dc.contributor.authorHumblet, P-
dc.contributor.authorHarries, A D-
dc.date.accessioned2008-01-31T15:40:53Z-
dc.date.available2008-01-31T15:40:53Z-
dc.date.issued2007-01-
dc.identifier.citationCommunity support is associated with better antiretroviral treatment outcomes in a resource-limited rural district in Malawi. 2007, 101 (1):79-84 Trans. R. Soc. Trop. Med. Hyg.en
dc.identifier.issn0035-9203-
dc.identifier.pmid16962622-
dc.identifier.doi10.1016/j.trstmh.2006.05.010-
dc.identifier.urihttp://hdl.handle.net/10144/17244-
dc.description.abstractA study was carried in a rural district in Malawi among HIV-positive individuals placed on antiretroviral treatment (ART) in order to verify if community support influences ART outcomes. Standardized ART outcomes in areas of the district with and without community support were compared. Between April 2003 (when ART was started) and December 2004 a total of 1634 individuals had been placed on ART. Eight hundred and ninety-five (55%) individuals were offered community support, while 739 received no such support. For all patients placed on ART with and without community support, those who were alive and continuing ART were 96 and 76%, respectively (P<0.001); death was 3.5 and 15.5% (P<0.001); loss to follow-up was 0.1 and 5.2% (P<0.001); and stopped ART was 0.8 and 3.3% (P<0.001). The relative risks (with 95% CI) for alive and on ART [1.26 (1.21-1.32)], death [0.22 (0.15-0.33)], loss to follow-up [0.02 (0-0.12)] and stopped ART [0.23 (0.08-0.54)] were all significantly better in those offered community support (P<0.001). Community support is associated with a considerably lower death rate and better overall ART outcomes. The community might be an unrecognized and largely 'unexploited resource' that could play an important contributory role in countries desperately trying to scale up ART with limited resources.en
dc.language.isoenen
dc.publisherElsevier
dc.relation.urlhttp://www.sciencedirect.com/science/journal-
dc.rightsArchived on this site with the kind permission of Elsevier Ltd. and the Royal Society of Tropical Medicine and Hygiene, http://www.rstmh.org/transactions.aspen
dc.subject.meshAdulten
dc.subject.meshAntiretroviral Therapy, Highly Activeen
dc.subject.meshCommunity Health Servicesen
dc.subject.meshFemaleen
dc.subject.meshHIV Infectionsen
dc.subject.meshHumansen
dc.subject.meshMalawien
dc.subject.meshMaleen
dc.subject.meshRural Healthen
dc.subject.meshSocial Supporten
dc.subject.meshTreatment Outcomeen
dc.titleCommunity support is associated with better antiretroviral treatment outcomes in a resource-limited rural district in Malawi.en
dc.contributor.departmentMédecins Sans Frontières, Medical Department (Operational Research), Brussels Operational Center, 68 Rue de Gasperich, L-1617, Luxembourg, Belgium. zachariah@internet.luen
dc.identifier.journalTransactions of the Royal Society of Tropical Medicine and Hygieneen

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