Outcomes of Antiretroviral Therapy Among Younger Versus Older Adolescents and Adults in an Urban Clinic, Zimbabwe

Hdl Handle:
http://hdl.handle.net/10144/615907
Title:
Outcomes of Antiretroviral Therapy Among Younger Versus Older Adolescents and Adults in an Urban Clinic, Zimbabwe
Authors:
Matyanga, C M J; Takarinda, K C; Owiti, P; Mutasa-Apollo, T; Mugurungi, O; Buruwe, L; Reid, A J
Journal:
Public Health Action
Abstract:
Setting: A non-governmental organisation-supported clinic offering health services including antiretroviral therapy (ART). Objective: To compare ART retention between younger (age 10–14 years) vs. older (age 15–19 years) adolescents and younger (age 20–29 years) vs. older (age 30 years) adults and determine adolescent- and adult-specific attrition-associated factors among those initiated on ART between 2010 and 2011. Design: Retrospective cohort study. Results: Of 110 (7%) adolescents and 1484 (93%) adults included in the study, no differences in retention were observed between younger vs. older adolescents at 6, 12 and 24 months. More younger adolescents were initiated with body mass index 16 kg/m2 compared with older adolescents (64% vs. 47%; P = 0.04). There were more females (74% vs. 52%, P  0.001) and fewer patients initiating ART with CD4 count 350 cells/mm3 (77% vs. 81%, P = 0.007) among younger vs. older adults. Younger adults demonstrated more attrition than older adults at all time-points. No attrition risk factors were observed among adolescents. Attrition-associated factors among adults included being younger, having a lower CD4 count and advanced human immunodeficiency virus disease at initiation, and initiation on a stavudine-based regimen. Conclusion: Younger adults demonstrated greater attrition and may require more attention. We were unable to demonstrate differences in attrition among younger vs. older adolescents. Loss to follow-up was the main reason for attrition across all age groups. Overall, earlier presentation for ART care appears important for improved ART retention among adults.
Publisher:
International Union Against TB and Lung Disease
Issue Date:
21-Jun-2016
URI:
http://hdl.handle.net/10144/615907
DOI:
10.5588/pha.15.0077
Additional Links:
http://openurl.ingenta.com/content/xref?genre=article&issn=2220-8372&volume=6&issue=2&spage=97
Submitted date:
2016-06-29
Language:
en
ISSN:
22208372; 22208372
Appears in Collections:
Operational Research Courses

Full metadata record

DC FieldValue Language
dc.contributor.authorMatyanga, C M Jen
dc.contributor.authorTakarinda, K Cen
dc.contributor.authorOwiti, Pen
dc.contributor.authorMutasa-Apollo, Ten
dc.contributor.authorMugurungi, Oen
dc.contributor.authorBuruwe, Len
dc.contributor.authorReid, A Jen
dc.date.accessioned2016-07-11T14:13:58Z-
dc.date.available2016-07-11T14:13:58Z-
dc.date.issued2016-06-21-
dc.date.submitted2016-06-29-
dc.identifier.citationOutcomes of antiretroviral therapy among younger versus older adolescents and adults in an urban clinic, Zimbabwe 2016, 6 (2):97 Public Health Actionen
dc.identifier.issn22208372-
dc.identifier.issn22208372-
dc.identifier.doi10.5588/pha.15.0077-
dc.identifier.urihttp://hdl.handle.net/10144/615907-
dc.description.abstractSetting: A non-governmental organisation-supported clinic offering health services including antiretroviral therapy (ART). Objective: To compare ART retention between younger (age 10–14 years) vs. older (age 15–19 years) adolescents and younger (age 20–29 years) vs. older (age 30 years) adults and determine adolescent- and adult-specific attrition-associated factors among those initiated on ART between 2010 and 2011. Design: Retrospective cohort study. Results: Of 110 (7%) adolescents and 1484 (93%) adults included in the study, no differences in retention were observed between younger vs. older adolescents at 6, 12 and 24 months. More younger adolescents were initiated with body mass index 16 kg/m2 compared with older adolescents (64% vs. 47%; P = 0.04). There were more females (74% vs. 52%, P  0.001) and fewer patients initiating ART with CD4 count 350 cells/mm3 (77% vs. 81%, P = 0.007) among younger vs. older adults. Younger adults demonstrated more attrition than older adults at all time-points. No attrition risk factors were observed among adolescents. Attrition-associated factors among adults included being younger, having a lower CD4 count and advanced human immunodeficiency virus disease at initiation, and initiation on a stavudine-based regimen. Conclusion: Younger adults demonstrated greater attrition and may require more attention. We were unable to demonstrate differences in attrition among younger vs. older adolescents. Loss to follow-up was the main reason for attrition across all age groups. Overall, earlier presentation for ART care appears important for improved ART retention among adults.en
dc.language.isoenen
dc.publisherInternational Union Against TB and Lung Diseaseen
dc.relation.urlhttp://openurl.ingenta.com/content/xref?genre=article&issn=2220-8372&volume=6&issue=2&spage=97en
dc.rightsArchived with thanks to Public Health Actionen
dc.titleOutcomes of Antiretroviral Therapy Among Younger Versus Older Adolescents and Adults in an Urban Clinic, Zimbabween
dc.identifier.journalPublic Health Actionen
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