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

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dc.contributor Medecins Sans Frontieres, Medical Department, Brussels, Belgium. zachariah@internet.lu
dc.creator Zachariah, Rony
dc.creator Harries, Katie
dc.creator Moses, Massaquoi
dc.creator Manzi, Marcel
dc.creator Line, Arnould
dc.creator Mwagomba, Beatrice
dc.creator Harries, Anthony D
dc.date 2009-07-15
dc.date.accessioned 2017-01-31T07:15:22Z
dc.date.available 2017-01-31T07:15:22Z
dc.identifier Very early mortality in patients starting antiretroviral treatment at primary health centres in rural Malawi. 2009, 14 (7):713-21 Trop. Med. Int. Health
dc.identifier 1365-3156
dc.identifier 19497082
dc.identifier 10.1111/j.1365-3156.2009.02291.x
dc.identifier http://hdl.handle.net/10144/83920
dc.identifier http://fieldresearch.msf.org/msf/handle/10144/83920
dc.identifier Tropical Medicine & International Health : TM & IH
dc.identifier.uri http://dspace.mediu.edu.my:8181/xmlui/handle/10144/83920
dc.description 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.
dc.language en
dc.rights Archived on this site with the kind permission of Wiley-Blackwell, [url]http://www.blackwell-synergy.com/loi/tmi[/url]
dc.title Very early mortality in patients starting antiretroviral treatment at primary health centres in rural Malawi.


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