Patient engagement in HIV care and treatment in Zambia, 2004-2014.
Trop Med Int Health
; 22(3): 332-339, 2017 03.
Article
em En
| MEDLINE
| ID: mdl-28102027
ABSTRACT
OBJECTIVE:
To describe engagement along the HIV continuum of care using a large network of clinics in Zambia.METHODS:
We employed a practical framework to describe retention along the HIV treatment cascade, using routinely collected clinical data available in resource-constrained settings. We included health facilities in four Zambian provinces with more than 300 enrolled patients over the age of 5 years. We described attrition at each step, from HIV enrolment to 720 days after ART initiation. The population was further stratified by year of enrolment to describe temporal trends in patient engagement.RESULTS:
From January 2004 to December 2014, 444 439 individuals over the age of 5 years sought HIV care at 75 eligible health facilities. Among those enrolled into HIV care, 82.1% (95% confidence interval [CI] 79.4-84.5%) were fully assessed for ART eligibility within 180 days of enrolment and 63.6% (95% CI 61.7-65.3) were found to be eligible for ART based on the HIV treatment guidelines at the time. Of those patients eligible for ART, 81.1% (95% CI 79.5-82.7%) initiated ART within 180 days. Patient retention in ART programme was 81.2% (95% CI 80.4-81.9%) at 90 days, 70.0% (95% CI 68.7-71.2%) at 360 days and 61.6% (95% CI 60.0-63.2%) at 720 days. We noted a steady decline in proportions assessed for ART eligibility and deemed eligible for ART in the time frame. Proportions that started ART and remained in care remained relatively consistent.CONCLUSION:
We describe a simple approach for assessing patient engagement after enrolment into HIV care. Using limited types of data routinely available, we demonstrate an important and replicable approach to monitoring programmes in resource-constrained settings.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Pacientes Desistentes do Tratamento
/
Infecções por HIV
/
Continuidade da Assistência ao Paciente
/
Fármacos Anti-HIV
/
Instalações de Saúde
Tipo de estudo:
Evaluation_studies
/
Guideline
Limite:
Adult
/
Female
/
Humans
/
Male
País/Região como assunto:
Africa
Idioma:
En
Ano de publicação:
2017
Tipo de documento:
Article