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    Jan 16, 2021
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    Payment for antiretroviral drugs is associated with a higher rate of patients lost to follow-up than those offered free-of-charge therapy in Nairobi, Kenya.

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    Authors
    Zachariah, R
    Van Engelgem, I
    Massaquoi, M
    Kocholla, L
    Manzi, M
    Suleh, A
    Philips, M
    Borgdorff, M
    Affiliation
    Médecins Sans Frontières - Brussels, Medical Department (Operational Research), 68 Rue de Gasperich, L-1617, Luxembourg.
    Issue Date
    2008-03
    
    Metadata
    Show full item record
    Journal
    Transactions of the Royal Society of Tropical Medicine and Hygiene
    Abstract
    This retrospective analysis of routine programme data from Mbagathi District Hospital, Nairobi, Kenya shows the difference in rates of loss to follow-up between a cohort that paid 500 shillings/month (approximately US$7) for antiretroviral drugs (ART) and one that received medication free of charge. A total of 435 individuals (mean age 31.5 years, 65% female) was followed-up for 146 person-years: 265 were in the 'payment' cohort and 170 in the 'free' cohort. The incidence rate for loss to follow-up per 100 person-years was 47.2 and 20.5, respectively (adjusted hazard ratio 2.27, 95% CI 1.21-4.24, P=0.01). Overall risk reduction attributed to offering ART free of charge was 56.6% (95% CI 20.0-76.5). Five patients diluted their ART regimen to one tablet (instead of two tablets) twice daily in order to reduce the monthly cost of medication by half. All these patients were from the payment cohort. Payment for ART is associated with a significantly higher rate of loss to follow-up, as some patients might be unable to sustain payment over time. In resource-limited settings, ART should be offered free of charge in order to promote treatment compliance and prevent the emergence of drug resistance.
    Publisher
    Elsevier
    URI
    http://hdl.handle.net/10144/22934
    DOI
    10.1016/j.trstmh.2007.12.007
    PubMed ID
    18258272
    Additional Links
    · http://www.sciencedirect.com/science/journal/00359203
    Language
    en
    ISSN
    0035-9203
    ae974a485f413a2113503eed53cd6c53
    10.1016/j.trstmh.2007.12.007
    Scopus Count
    Collections
    HIV/AIDS

    entitlement

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