Antiretroviral Therapy in Public and Private Routine Health Care Clinics in Cameroon: Lessons from the Douala Antiretroviral (DARVIR) Initiative

Laurent, Christian; Meilo, Henriette; Guiard–Schmid, Jean–Baptiste; Mapoure, Yacouba Njankouo; Noël, Jeanne-Marie; Mbangue, Madeleine; Joko, Ashu; Rozenbaum, Willy; Ntoné, Fritz Ntoné; Delaporte, Eric

doi:10.1086/430712

Cited by 37 publications

(36 citation statements)

References 12 publications

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“…These high levels of adherence confirm findings in other resource-limited settings (Byakika-Tusiime et al 2005;Fong et al 2003;Landman et al 2003;Laniece et al 2003;Laurent et al 2004;Laurent et al 2005a, b;Nachega et al 2004;Orrell et al 2003;Oyugi et al 2004;Remien et al 2003;Weidle et al 2002;Weiser et al 2003). Our findings contrast with those of Merenstein et al (2008), who found an inverse relationship between adherence and the number of children in the family.…”

Section: Discussionsupporting

confidence: 82%

“…While most studies have shown high levels of adherence to ART in resource-constrained settings Bisson et al 2008;Byakika-Tusiime et al 2005;Diabate et al 2007;Etard et al 2007;Fong et al 2003;Landman et al 2003;Laniece et al 2003;Laurent et al 2004;Laurent et al 2005a, b;Mills et al 2006b;Nachega et al 2004;Orrell et al 2003;Oyugi et al 2004;Remien et al 2003;San Lio et al 2008;Tadios and Davey 2006;Weidle et al 2002;Weidle et al 2006;Weiser et al 2003) there has been little discussion about how HIV? women balance the demands of adherence to HIV ART, childcare, and antiretroviral adherence among their children who are HIV-infected.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Longitudinal Antiretroviral Adherence in HIV+ Ugandan Parents and Their Children Initiating HAART in the MTCT-Plus Family Treatment Model: Role of Depression in Declining Adherence Over Time

et al. 2009

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We conducted a study to assess the effect of family-based treatment on adherence amongst HIV-infected parents and their HIV-infected children attending the Mother-To-Child-Transmission Plus program in Kampala, Uganda. Adherence was assessed using home-based pill counts and self-report. Mean adherence was over 94%. Depression was associated with incomplete adherence on multivariable analysis. Adherence declined over time. Qualitative interviews revealed lack of transportation money, stigma, clinical response to therapy, drug packaging, and cost of therapy may impact adherence. Our results indicate that providing ART to all eligible HIV-infected members in a household is associated with excellent adherence in both parents and children. Adherence to ART among new parents declines over time, even when patients receive treatment at no cost. Depression should be addressed as a potential barrier to adherence. Further study is necessary to assess the long-term impact of this family treatment model on adherence to ART in resource-limited settings.

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Section: Discussionsupporting

confidence: 82%

Section: Introductionmentioning

confidence: 99%

Longitudinal Antiretroviral Adherence in HIV+ Ugandan Parents and Their Children Initiating HAART in the MTCT-Plus Family Treatment Model: Role of Depression in Declining Adherence Over Time

et al. 2009

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“…The more the number of such patients, the more the opportunities for development and transmission of drug-resistant strains of HIV. At a median period of follow-up of 14 months, LTF of nearly a third of enrollees in the public facility could be considered quite significant, and the figure is similar to those from studies of similar duration of follow-up in Cameroon, 21 Kenya, 22 and…”

Section: Discussionsupporting

confidence: 71%

Retention and loss to follow-up in antiretroviral treatment programmes in southeast Nigeria

Onoka

Uzochukwu

Onwujekwe

et al. 2012

Pathogens and Global Health

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Background: This study generated new information about the outcomes of patients enrolled in antiretroviral treatment programmes, as well as the true outcomes of those lost to follow-up (LTF). Methods: Anonymized data were collected for patients enrolled over a 12-month period from two programmes (public and private) in southeast Nigeria. Estimates of retention, LTF, mortality and transfers were computed. All LTF enrollees (defined as patients who had missed three scheduled visits) whose contact information met pre-defined criteria were traced. Results: A total of 481 (public) and 553 (private) records were included. Median duration of follow-up was about 14 months. Cumulative retention and LTF proportions were 66.5 and 32.8% (public), and 82.6 and 11.0% (private) respectively. LTF rates at third, sixth, ninth and twelfth months were 7.5, 19.3, 25.4 and 29.6% respectively (public), and 4.1, 7.1, 9.0 and 10.0% (private). LTF was higher among males, patients with CD4z cell count (200 and public programme enrollees. For the public facility, 56.7% of 104 traceable patients were dead and 38.8% were alive; the figures were 34.2 and 60.5% of 46 patients respectively for the private. Most deaths had occurred by the third month. Conclusion: Not all patients enrolled for treatment were retained. Though some died, many were LTF, lived within the community, and could develop and transmit resistant viral stains. Most traced patients were dead by the third month and poor contact information limited the effectiveness of tracing. Antiretroviral treatment programmes need to improve documentation processes and develop and implement tracing strategies.

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“…Other studies conducted in resource-limited settings have shown that cost of ART is an insurmountable obstacle for many individuals, contributing to loss to follow-up, poor adherence to treatment, reduced ART efficacy and reduced access to HIV care, particularly for marginalized groups (Bission et al, 2006;Ivers et al, 2005;Laurent et al, 2005;Oosterhout et al, 2005). The clear way forward to avoid this obstacle is to abolish any fee associated with ART.…”

Section: Discussionmentioning

confidence: 99%

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

Zachariah

Engelgem

Massaquoi

et al. 2008

Transactions of the Royal Society of Tropical Medicine and Hygi

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Antiretroviral Therapy in Public and Private Routine Health Care Clinics in Cameroon: Lessons from the Douala Antiretroviral (DARVIR) Initiative

Cited by 37 publications

References 12 publications

Longitudinal Antiretroviral Adherence in HIV+ Ugandan Parents and Their Children Initiating HAART in the MTCT-Plus Family Treatment Model: Role of Depression in Declining Adherence Over Time

Longitudinal Antiretroviral Adherence in HIV+ Ugandan Parents and Their Children Initiating HAART in the MTCT-Plus Family Treatment Model: Role of Depression in Declining Adherence Over Time

Retention and loss to follow-up in antiretroviral treatment programmes in southeast Nigeria

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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