| dc.contributor |
Médecins sans Frontières, Medical Department (Operational Research), Brussels Operational Center, 68 Rue de Gasperich, L-1617, Luxembourg. |
|
| dc.creator |
Tayler-Smith, Katie |
|
| dc.creator |
Zachariah, Rony |
|
| dc.creator |
Massaquoi, M |
|
| dc.creator |
Massaquoi, M |
|
| dc.creator |
Manzi, Marcel |
|
| dc.creator |
Pasulani, Olesi |
|
| dc.creator |
van den Akker, Thomas |
|
| dc.creator |
Bemelmans, Marielle |
|
| dc.creator |
Bauernfeind, Ariane |
|
| dc.creator |
Mwagomba, Beatrice |
|
| dc.creator |
Harries, Anthony D |
|
| dc.date |
2010-05 |
|
| dc.date.accessioned |
2017-01-31T07:16:57Z |
|
| dc.date.available |
2017-01-31T07:16:57Z |
|
| dc.identifier |
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? 2010, 104 (5):313-9 Trans. R. Soc. Trop. Med. Hyg. |
|
| dc.identifier |
1878-3503 |
|
| dc.identifier |
20138323 |
|
| dc.identifier |
10.1016/j.trstmh.2010.01.007 |
|
| dc.identifier |
http://hdl.handle.net/10144/98743 |
|
| dc.identifier |
http://fieldresearch.msf.org/msf/handle/10144/98743 |
|
| dc.identifier |
Transactions of the Royal Society of Tropical Medicine and Hygiene |
|
| dc.identifier.uri |
http://dspace.mediu.edu.my:8181/xmlui/handle/10144/98743 |
|
| dc.description |
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. |
|
| dc.language |
en |
|
| dc.rights |
Published by Elsevier
Archived on this site with the kind permission of Elsevier Ltd. ([url]http://www.sciencedirect.com/science/journal/00359203[/url]) and the Royal Society of Tropical Medicine and Hygiene ([url]http://www.rstmh.org/transactions.asp[/url]) |
|
| dc.title |
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? |
|