High loss to follow-up of children on antiretroviral treatment in a primary care HIV clinic in Johannesburg, South Africa

Medicine
Nomathemba ChandiwanaLee Fairlie

Abstract

Outcomes of HIV-infected children have improved dramatically over the past decade, but are undermined by patient loss to follow-up (LTFU). We assessed patterns of LTFU among HIV-infected children receiving antiretroviral treatment (ART) at a large inner-city HIV clinic in Johannesburg, South Africa between 2005 and 2014.Demographic and clinical data were extracted from clinic records of children under 12 years. Differences between characteristics of children retained in care and LTFU were assessed using Wilcoxon rank sum tests or Pearson χ tests. Cox proportional hazard models then identified characteristics associated with LTFU.Of 135 children, the median age at ART initiation was 21.5 months (IQR: 6.3-47.7) with a median follow-up time of 3.3 years (IQR: 1.4-5.0). The incidence rate of LTFU was 10.8 per 100 person-years (95% CI: 8.2-14.4); cumulatively 36% of children were LTFU. Almost a third (n = 39) of children missed a clinic visit, but then returned to care; 77% of these were eventually LTFU. In total, 18% of children had elevated viral loads after 6 or more months of ART. Older age at ART initiation (18-59 months: aHR 1.6, 95% CI: 3.9-14.2) and ever missing a clinic visit (aHR 7.4 95% CI: 3.9-14.2) were independent pred...Continue Reading

References

Sep 7, 2007·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Ali JuddUNKNOWN National Study of HIV in Pregnancy and Childhood (NSHPC)
Nov 21, 2008·The New England Journal of Medicine·Avy ViolariUNKNOWN CHER Study Team
Dec 17, 2008·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Michael J MugaveroJeroan J Allison
May 22, 2010·Tropical Medicine & International Health : TM & IH·Paula BraitsteinSamwel Ayaya
Jul 14, 2010·Tropical Medicine & International Health : TM & IH·Anthony D HarriesSydney Rosen
Jul 1, 2010·Journal of Acquired Immune Deficiency Syndromes : JAIDS·Lukas FennerUNKNOWN International epidemiologic Databases to Evaluate AIDS in Southern Africa
Jan 13, 2011·Journal of Acquired Immune Deficiency Syndromes : JAIDS·Maureen BraunMina C Hosseinipour
Jul 14, 2012·Journal of the International AIDS Society·Yabsera MarcosGretchen Bachman
Nov 29, 2012·Journal of Acquired Immune Deficiency Syndromes : JAIDS·Valeriane LeroyUNKNOWN International IeDEA Pediatric Working Group1
Dec 4, 2012·Lancet·Bongani M MayosiUNKNOWN Lancet South Africa team
Jan 26, 2013·The Pediatric Infectious Disease Journal·Thorbjörn LundbergHerbert Sandström
Dec 24, 2013·AIDS·B Ryan PhelpsUNKNOWN Child Survival Working Group of the Interagency Task Team on the Prevention, Treatment of HIV infection in Pregnant Women, M
Dec 24, 2013·AIDS·Saeed AhmedUNKNOWN Child Survival Working Group of the Interagency Task Team on the Prevention and Treatment of HIV infection in Pregnant Women
Jan 1, 2014·The Pediatric Infectious Disease Journal·Mary-Ann DaviesUNKNOWN IeDEA Southern Africa Collaboration
Dec 4, 2014·Journal of Acquired Immune Deficiency Syndromes : JAIDS·Selamawit A WoldesenbetGayle G Sherman
Jul 15, 2015·Journal of Acquired Immune Deficiency Syndromes : JAIDS·Mireille PorterBrian Eley
Aug 19, 2015·South African Family Practice : Official Journal of the South African Academy of Family Practice/Primary Care·Karl le RouxEmily Davis
Oct 8, 2016·Current Opinion in HIV and AIDS·Mary-Ann DaviesAnna Turkova
Aug 5, 2017·Journal of the International AIDS Society·Anna GrimsrudNathan Ford
Aug 24, 2017·BMC Public Health·Helen ReesMatthew F Chersich

❮ Previous
Next ❯

Software Mentioned

STATA

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.