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Home >> Publications >> Outcomes and associated risk factors of patients traced after being lost to follow-up from antiretroviral treatment in Lilongwe, Malawi.

Publication

Author(s):

Weigel R, Hochgesang M, Brinkhof MW, Hosseinipour MC, Boxshall M, Mhango E, Nkwazi B, Tweya H, Kamlaka M, Chagwera F, Phiri S.

Pub Title:

Outcomes and associated risk factors of patients traced after being lost to follow-up from antiretroviral treatment in Lilongwe, Malawi.

Pub Date:

Jan 27 2011

Pub Region(s):

Southern Africa

Page Number:
11628

Journal:

Title: 
BMC Infectious Diseases
Link: 
http://www.biomedcentral.com/1471-2334/11/31

PubMed: 21272350
Pub PDF: PDF icon 21272350.pdf

Abstract
BACKGROUND
: Loss to follow-up is a major challenge of antiretroviral treatment (ART) programs in sub-Saharan Africa. Our objective was to a) determine true outcomes of patients lost to follow-up (LTFU) and b) identify risk factors associated with successful tracing and deaths of patients LTFU from ART in a large public sector clinic in Lilongwe, Malawi.

METHODS: Patients who were more than 2 weeks late according to their last ART supply and who provided a phone number or address in Lilongwe were eligible for tracing. Their outcomes were updated and risk factors for successful tracing and death were examined.

RESULTS: Of 1800 patients LTFU with consent for tracing, 724 (40%) were eligible and tracing was successful in 534 (74%): 285 (53%) were found to be alive and on ART; 32 (6%) had stopped ART; and 217 (41%) had died. Having a phone contact doubled tracing success (adjusted odds ratio, aOR = 2.1, 95% CI 1.4-3.0) and odds of identifying deaths [aOR = 1.8 (1.2-2.7)] in patients successfully traced. Mortality was higher when ART was fee-based at initiation (aOR = 2.3, 95% CI 1.1-4.7) and declined with follow-up time on ART. Limiting the analysis to patients living in Lilongwe did not change the main findings.

CONCLUSION: Ascertainment of contact information is a prerequisite for tracing, which can reveal outcomes of a large proportion of patients LTFU. Having a phone contact number is critical for successful tracing, but further research should focus on understanding whether phone tracing is associated with any differential reporting of mortality or LTFU.

PMID: 21272350 [PubMed - indexed for MEDLINE]

PMCID: PMC3039578

 

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Citation:

Weigel R, Hochgesang M, Brinkhof MW, Hosseinipour MC, Boxshall M, Mhango E, Nkwazi B, Tweya H, Kamlaka M, Chagwera F, Phiri S. Outcomes and associated risk factors of patients traced after being lost to follow-up from antiretroviral treatment in Lilongwe, Malawi. BMC Infect Dis. 2011 Jan 27;11:31. doi: 10.1186/1471-2334-11-31. PubMed PMID: 21272350; PubMed Central PMCID: PMC3039578.