Evaluation of Three Sampling Methods to Monitor Outcomes of Antiretroviral Treatment Programmes in Low- and Middle-Income Countries.
Harries, A D
AffiliationDepartment of HIV/AIDS, World Health Organisation, Geneva, Switzerland.
MetadataShow full item record
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.
- Gender differences in retention and survival on antiretroviral therapy of HIV-1 infected adults in Malawi.
- Authors: Taylor-Smith K, Tweya H, Harries A, Schoutene E, Jahn A
- Issue date: 2010 Jun
- Implementation and Operational Research: High Loss to Follow-up Among Children on Pre-ART Care Under National AIDS Program in Madurai, South India.
- Authors: Ganga Devi NP, Ajay KM, Palanivel C, Sahu S, Selvaraj M, Valan AS, Rewari BB, Soumya S
- Issue date: 2015 Jul 1
- Correcting mortality for loss to follow-up: a nomogram applied to antiretroviral treatment programmes in sub-Saharan Africa.
- Authors: Egger M, Spycher BD, Sidle J, Weigel R, Geng EH, Fox MP, MacPhail P, van Cutsem G, Messou E, Wood R, Nash D, Pascoe M, Dickinson D, Etard JF, McIntyre JA, Brinkhof MW, IeDEA East Africa, West Africa and Southern Africa.
- Issue date: 2011 Jan 18
- Patient retention in antiretroviral therapy programs in sub-Saharan Africa: a systematic review.
- Authors: Rosen S, Fox MP, Gill CJ
- Issue date: 2007 Oct 16
- Self-transfer and mortality amongst adults lost to follow-up in ART programmes in low- and middle-income countries: systematic review and meta-analysis.
- Authors: Wilkinson LS, Skordis-Worrall J, Ajose O, Ford N
- Issue date: 2015 Mar