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    Jan 15, 2021
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    Unacceptable attrition among WHO stages 1 and 2 patients in a hospital-based setting in rural Malawi: can we retain such patients within the general health system?

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    Tayler-Smith HIV Retention Malawi ...
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    Authors
    Tayler-Smith, Katie
    Zachariah, Rony
    Massaquoi, M
    Massaquoi, M
    Manzi, Marcel
    Pasulani, Olesi
    van den Akker, Thomas
    Bemelmans, Marielle
    Bauernfeind, Ariane
    Mwagomba, Beatrice
    Harries, Anthony D
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    Affiliation
    Médecins sans Frontières, Medical Department (Operational Research), Brussels Operational Center, 68 Rue de Gasperich, L-1617, Luxembourg.
    Issue Date
    2010-05
    
    Metadata
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    Journal
    Transactions of the Royal Society of Tropical Medicine and Hygiene
    Abstract
    A study conducted among HIV-positive adults in WHO clinical stages 1 and 2 was followed up at Thyolo District Hospital (rural Malawi) to report on: (1) retention and attrition before and while on antiretroviral treatment (ART); and (2) the criteria used for initiating ART. Between June 2008 and January 2009, 1633 adults in WHO stages 1 and 2 were followed up for a total of 282 person-years. Retention in care at 1, 2, 3 and 6 months for those not on ART (n=1078) was 25, 18, 11 and 4% vs. 99, 97, 95 and 90% for patients who started ART (n=555, P=0.001). Attrition rates were 31 times higher among patients not started on ART compared with those started on ART (adjusted hazard ratio, 31.0, 95% CI 22-44). Ninety-two patients in WHO stage 1 or 2 were started on ART without the guidance of a CD4 count, and 11 were incorrectly started on ART with CD4 count > or = 250 cells/mm(3). In a rural district hospital setting in Malawi, attrition of individuals in WHO stages 1 and 2 is unacceptably high, and specific operational strategies need to be considered to retain such patients in the health system.
    URI
    http://hdl.handle.net/10144/98743
    DOI
    10.1016/j.trstmh.2010.01.007
    PubMed ID
    20138323
    Language
    en
    ISSN
    1878-3503
    ae974a485f413a2113503eed53cd6c53
    10.1016/j.trstmh.2010.01.007
    Scopus Count
    Collections
    HIV/AIDS

    entitlement

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