Very early mortality in patients starting antiretroviral treatment at primary health centres in rural Malawi.

Hdl Handle:
http://hdl.handle.net/10144/83920
Title:
Very early mortality in patients starting antiretroviral treatment at primary health centres in rural Malawi.
Authors:
Zachariah, Rony; Harries, Katie; Moses, Massaquoi; Manzi, Marcel; Line, Arnould; Mwagomba, Beatrice; Harries, Anthony D
Journal:
Tropical Medicine & International Health : TM & IH
Abstract:
OBJECTIVES: To report on the cumulative proportion of deaths occurring within 3 months of starting antiretroviral treatment (ART) and to identify factors associated with such deaths, among adults at primary health centres in a rural district of Malawi. METHODS: Retrospective cohort study: from June 2006 to April 2008, deaths occurring over a 3-month period were determined and risk factors examined. RESULTS: A total of 2316 adults (706 men and 1610 women; median age 35 years) were included in the analysis and followed up for a total of 1588 person-years (PY); 277 (12%) people died, of whom 206 (74%) people died within 3 months of initiating ART (cumulative incidence: 13.0; 95% confidence interval: 11.3-14.8 per 100 PY of follow-up). Significant risk factors associated with early deaths included male sex, WHO stage 4 disease, oesophageal or persistent oral candidiasis and unexplained presumed or measured weight loss >10%. One in every 3 patients who either died or was lost to follow up had unexplained weight loss >10%, and survival in this group was significantly different from patients without this condition. CONCLUSIONS: Seven in 10 individuals initiating ART at primary health centres die early. Specific groups of patients are at higher risk of such mortality and should receive priority attention, care and support.
Affiliation:
Medecins Sans Frontieres, Medical Department, Brussels, Belgium. zachariah@internet.lu
Issue Date:
15-Jul-2009
URI:
http://hdl.handle.net/10144/83920
DOI:
10.1111/j.1365-3156.2009.02291.x
PubMed ID:
19497082
Language:
en
ISSN:
1365-3156
Appears in Collections:
HIV/AIDS

Full metadata record

DC FieldValue Language
dc.contributor.authorZachariah, Ronyen
dc.contributor.authorHarries, Katieen
dc.contributor.authorMoses, Massaquoien
dc.contributor.authorManzi, Marcelen
dc.contributor.authorLine, Arnoulden
dc.contributor.authorMwagomba, Beatriceen
dc.contributor.authorHarries, Anthony Den
dc.date.accessioned2009-10-09T10:26:04Z-
dc.date.available2009-10-09T10:26:04Z-
dc.date.issued2009-07-15-
dc.identifier.citationVery early mortality in patients starting antiretroviral treatment at primary health centres in rural Malawi. 2009, 14 (7):713-21 Trop. Med. Int. Healthen
dc.identifier.issn1365-3156-
dc.identifier.pmid19497082-
dc.identifier.doi10.1111/j.1365-3156.2009.02291.x-
dc.identifier.urihttp://hdl.handle.net/10144/83920-
dc.description.abstractOBJECTIVES: To report on the cumulative proportion of deaths occurring within 3 months of starting antiretroviral treatment (ART) and to identify factors associated with such deaths, among adults at primary health centres in a rural district of Malawi. METHODS: Retrospective cohort study: from June 2006 to April 2008, deaths occurring over a 3-month period were determined and risk factors examined. RESULTS: A total of 2316 adults (706 men and 1610 women; median age 35 years) were included in the analysis and followed up for a total of 1588 person-years (PY); 277 (12%) people died, of whom 206 (74%) people died within 3 months of initiating ART (cumulative incidence: 13.0; 95% confidence interval: 11.3-14.8 per 100 PY of follow-up). Significant risk factors associated with early deaths included male sex, WHO stage 4 disease, oesophageal or persistent oral candidiasis and unexplained presumed or measured weight loss >10%. One in every 3 patients who either died or was lost to follow up had unexplained weight loss >10%, and survival in this group was significantly different from patients without this condition. CONCLUSIONS: Seven in 10 individuals initiating ART at primary health centres die early. Specific groups of patients are at higher risk of such mortality and should receive priority attention, care and support.en
dc.language.isoenen
dc.rightsArchived on this site with the kind permission of Wiley-Blackwell, [url]http://www.blackwell-synergy.com/loi/tmi[/url]en
dc.subject.meshAIDS-Related Opportunistic Infectionsen
dc.subject.meshAdulten
dc.subject.meshAnti-Retroviral Agentsen
dc.subject.meshCD4 Lymphocyte Counten
dc.subject.meshCandidiasis, Oralen
dc.subject.meshEpidemiologic Methodsen
dc.subject.meshFemaleen
dc.subject.meshHIV-1en
dc.subject.meshHumansen
dc.subject.meshMalawien
dc.subject.meshMaleen
dc.subject.meshMalnutritionen
dc.subject.meshPractice Guidelines as Topicen
dc.subject.meshRural Healthen
dc.subject.meshTuberculosis, Pulmonaryen
dc.subject.meshWeight Lossen
dc.titleVery early mortality in patients starting antiretroviral treatment at primary health centres in rural Malawi.en
dc.contributor.departmentMedecins Sans Frontieres, Medical Department, Brussels, Belgium. zachariah@internet.luen
dc.identifier.journalTropical Medicine & International Health : TM & IHen

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