Loss to Follow-Up of Adults in Public HIV Care Systems in Central Mozambique: Identifying Obstacles to Treatment

Micek, Mark A.; Gimbel-Sherr, Kenneth; Baptista, Alberto; Matediana, Eduardo; Montoya, Pablo; Pfeiffer, James; Melo, Armando; Gimbel-Sherr, Sarah Odell; Johnson, W.; Gloyd, Stephen

doi:10.1097/qai.0b013e3181ab73e2

Cited by 119 publications

(139 citation statements)

References 39 publications

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“…11,[13][14][15] In a semiprivate clinic in Durban with a high prevalence of HIV infection (63% of all patients tested), about 53% of the patients with newly-diagnosed HIV infection did not complete CD4 testing within 8 weeks. In a small community outside Cape Town, 62% of patients who tested positive for HIV infection completed CD4 testing within 6 months of testing positive.…”

Section: Discussionmentioning

confidence: 99%

Lost opportunities to complete CD4+ lymphocyte testing among patients who tested positive for HIV in South Africa

Larson

Brennan

McNamara

et al. 2010

Bull. World Health Organ.

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Section: Discussionmentioning

confidence: 99%

Lost opportunities to complete CD4+ lymphocyte testing among patients who tested positive for HIV in South Africa

Larson

Brennan

McNamara

et al. 2010

Bull. World Health Organ.

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“…This result is in accordance of study from Brinkhof, Rodrigues, and Egger (2009) that showed common reasons for not returning the clinic to take ARV are transfer to another program, financial problems, improving or deteriorating health and death. Another study by Micek et al (2009) in developed countries also shows that follow-up with chronic care is also influenced by "the perceived need for treatment, satisfaction with care, and the quality of provider-patient relationships. Stigma, an unfamiliarity with chronic care, limited human resource capacity, a cumbersome pre-ART preparation process, and transportation as additional factors".…”

Section: Discussionmentioning

confidence: 99%

“…The period of LTFU patients to be traced is 3 weeks from their last schedule (Weigel et al 2011). Another adherence support strategy including pre-ART counseling visit, community-based groups in adherence support, treatment partners, giving modified directly observed therapy ang tracing patients who did not refill medication (Micek et al 2009). …”

Section: Discussionmentioning

confidence: 99%

Lost to Follow-Up : Reasons and True Outcome for Patients on Arv Treatment in Teratai Clinic Bandung Indonesia

Haroen¹,

Puspitasari²,

Borne³

et al. 2017

JPKI

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Klinik RSHS Teratai HIV telah merawat pasien dari September 2004 sampai Desember 2009, sebanyak 2.060 ODHA dan 1290 menerima ARV (63%). Selama periode ini, sebesar 11% (141 orang) kehilangan kontak lebih tinggi dari keseluruhan persentase di Indonesia yaitu 10,7% (Depkes, 2009). Tujuan dari penelitian ini adalah untuk menyelidiki hasil yang benar dan faktor hilang tindak lanjut ARV di klinik RSHS Teratai ARV. Penelitian ini menggunakan metode wawancara mendalam dengan 25 pasien HIV / AIDS bawah pengobatan ARV di klinik Teratai RSHS dan mangkir sejak tahun 2009 yang tinggal di daerah Bandung. Informan dipilih secara acak dan dihubungi untuk kunjungan rumah untuk diwawancarai oleh pewawancara yang berpengalaman. Peneliti melakukan wawancara mendalam di rumah pasien sekitar 60 menit. Data direkam oleh pita digital direkam, ditranskrip dan dicetak oleh dua peneliti bidang independen menggunakan analisis tematik.Hasil penelitian ini menunjukkan tujuh tema yang pengetahuan yang tidak benar, optimisme yang tidak realistis, masalah aadministratif, perasaan efek samping negatif, masalah interpersonal, masalah kecanduan, dan kurangnya perawatan diri. Oleh karena itu, penting untuk mengembangkan tindakan pencegahan melalui rincian kontak pasien, meminta pasien persetujuan untuk dihubungi, telepon, kunjungan rumah setelah 3 minggu kehilangan kontak, dan menyarankan pasien untuk mendaftar ke klinik ART lebih dekat dengan rumah mereka , dan mengembangkan sistem reminder untuk mengingatkan pasien untuk mengambil ARV tepat waktu. ABSTRACTTeratai clinic HIV RSHS has treated patients from September 2004 to December 2009, as much as 2060 PLWHA and 1290 receive ARV (63%). Over this period, 11% (141) were lost to follow-up that is higher than overall lost to follow up percentage in Indonesia which is 10.7% (MOH annually report December 2009). The aim of this study was to investigate the true outcomes and factors of lost follow up to ARV. This study used indepth interview method to 25 HIV/AIDS patients under ARV treatment in the Teratai clinic RSHS and lost to follow up since 2009 who lived in Bandung area. Informants were randomly selected and contacted for a home visit to be interviewed by experienced interviewer. The interviewers obtained verbal informed consent and conducted an in depth interview in the patients home. Interview took about 60 minutes. Data were recorded by digital tape recorded, transcribed and scored by two field researchers independently using thematic analysis. The result of this study shows seven themes which are incorrect knowledge, unrealistic optimism, administrative problems, feeling of negative side effect, interpersonal problem, addiction problem, and lack of self-care. Therefore, it is important to develop preventive measure through up-dating patients’ contact details, ask patients consent to be contacted, up date phone contact, home visit after 3 weeks lost of contact, advice patients to register to ART clinic closer to their homes, and develop a reminding system to remind patients to take ARV on time.

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“…However, the nature of a centralized laboratory demands that patients attend on separate days for testing and treatment, which strains patients' time and resources [11,12]. As a consequence, estimates from studies suggest that only about 60% (range 35-88%) of individuals who receive an HIV diagnosis in sub-Saharan Africa receive a CD4+ count, meaning many remain oblivious to the need for treatment initiation or switching [3].…”

Section: Introductionmentioning

confidence: 99%

“…In global settings, patients are often required to travel long distances to clinics with specialized central laboratories to be staged and initiated on ART [11,12]. However, the nature of a centralized laboratory demands that patients attend on separate days for testing and treatment, which strains patients' time and resources [11,12].…”

Section: Introductionmentioning

confidence: 99%

Head to head comparisons in performance of CD4 point-of-care assays: a Bayesian meta-analysis (2000–2013)

Pai

Wilkinson

Chiavegatti

et al. 2014

ScienceOpen Research

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Timely detection, staging, and treatment initiation are pertinent to controlling HIV infection. CD4+ cell-based point-of-care (POC) devices offer the potential to rapidly stage patients, and decide on initiating treatment, but a comparative evaluation of their performance has not yet been performed. With this in mind, we conducted a systematic review and metaanalyses. For the period January 2000 to April 2014, 19 databases were systematically searched, 6619 citations retrieved, and 25 articles selected. Diagnostic performance was compared across devices (i.e., PIMA, CyFlow, miniPOC, MBioCD4 System) and across specimens (i.e., capillary blood vs. venous blood). A Bayesian approach was used to meta-analyze the data. The primary outcome, the Bland-Altman (BA) mean bias (which represents agreement between cell counts from POC device and flow cytometry), was analyzed with a Bayesian hierarchical normal model. We performed a headto-head comparison of two POC devices including the PIMA and PointCareNOW CD4. PIMA appears to perform better vs. PointCareNOW with venous samples (BA mean bias: -9.5 cells/μL; 95% CrI: -37.71 to 18.27, vs. 139.3 cells/μL; 95% CrI: -0.85 to 267.4, mean difference = 148.8, 95% CrI: 11.8, 285.8); importantly, PIMA performed well when used with capillary samples (BA mean bias: 2.2 cells/μL; 95% CrI: -19.32 to 23.6). Sufficient data were available to allow pooling of sensitivity and specificity data only at the 350 cells/μL cutoff. For PIMA device sensitivity 91.6 (84.7-95.5) and specificity was 94.8 (90.1-97.3), respectively. There were not sufficient data to allow comparisons between any other devices. PIMA device was comparable to flow cytometry. The estimated differences between the CD4+ cell counts of the device and the reference was small and best estimated in capillary blood specimens. As the evidence stands, the PointCareNOW device will need to improve prior to widespread use and more data on MBio and MiniPOC are needed. Findings inform implementation of PIMA and improvements in other CD4 POC device prior to recommending widespread use.

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Loss to Follow-Up of Adults in Public HIV Care Systems in Central Mozambique: Identifying Obstacles to Treatment

Cited by 119 publications

References 39 publications

Lost opportunities to complete CD4+ lymphocyte testing among patients who tested positive for HIV in South Africa

Lost opportunities to complete CD4+ lymphocyte testing among patients who tested positive for HIV in South Africa

Lost to Follow-Up : Reasons and True Outcome for Patients on Arv Treatment in Teratai Clinic Bandung Indonesia

Head to head comparisons in performance of CD4 point-of-care assays: a Bayesian meta-analysis (2000–2013)

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