Caractéristiques des patients « perdus de vue » et facteurs déterminants de la perte de vue au cours du suivi des patients infectés par le VIH à Ouagadougou, Burkina Faso

Bognounou, Réné; Kaboré, Mikaïla; Diendéré, Arnaud Eric; Diallo, I; Sagna, Yempabou; Guira, Oumar; Tiéno, H.; Ouédraogo, Dieu-Donné; Drabo, Y. J.

doi:10.1007/s13149-015-0424-7

Cited by 8 publications

(8 citation statements)

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“…Attrition was dominated by a high prevalence of lost to follow up (20%). This prevalence is comparable on those described in India [27], higher than those described in Burkina Faso [28] and South Africa [29].…”

Section: Discussionsupporting

confidence: 87%

Factors Associated with Adverse Therapeutic Outcomes in People Living with HIV (PLHIV) Monitored in Roi Baudouin Health Care Center, Dakar, Senegal

Ba¹,

Ba²,

Sembene³

et al. 2020

WJA

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Background: Optimizing antiretroviral therapy is an essential step to reach the 90 -90 -90 targets. Despite tremendous progress made for antiretroviral treatment (ART) to be accessible in countries with limited resources, health care providers continue to face challenges due to the under-optimization of ART due to therapeutic failures and poor retention. Objectives: To determine the prevalence of adverse therapeutic outcomes in a decentralized health care center and to determine associated factors. Patients and Methods: This is a cross-sectional descriptive and analytical study targeting PLHIV, aged 18 years and over, on first line antiretroviral treatment (ART), monitored onsite from February 1st to December 31st, 2018. A data collection form was completed from medical records (clinical, immuno-virological, therapeutic and evolutionary). Data were also collected from interviews with patients for additional socio-demographic information including the level of HIV knowledge. Data were captured and analyzed using EPI 2002 and R software. Proportions were compared using the chi -square and Fisher tests and logistic regression. A value of p < 0.05 was considered significant. Results: 331 patients were enrolled with HIV-1 profile in 89% of the cases. A proportion of 55% was married and 98% came from the rural area. 80% were either not or poorly educated. The median of age was 44 ± 11 years with a F/M ratio of 3.5. 30% that had not shared their HIV status, and more than half had a low knowledge of HIV transmission. At baseline, 56% were symp-How to cite this paper: Baat WHO stage 3 or 4. They had severe immunosuppression with a median CD4 count of 217 ± 187 cells/mm 3 ; the viral load was detectable in half of the patients with a median viral load (VL) of 97,000 ± 70,569 cp/ml. The antiretroviral regimens combined 2 nucleoside reverse transcriptase inhibitor (NRTI) with 1 no nucleoside reverse transcriptase inhibitor (NNRTI) in 88% of the cases. The median duration of follow-up was estimated at 60 ± 43 months. The prevalence of adverse therapeutic outcomes was 36% (119 patients). The proportion of virological failure was 19%, lost follow up was 20% and the mortality was 4%. The adverse therapeutic outcomes were associated with the age less than 25 years (p = 0.007) and with a late diagnosis (CD4 T cells at baseline less than 200 cell/mm 3 , p = 0.02). Conclusion: These results suggest the need to make new therapeutic classes available for first-line treatment and to promote actions improving retention in care.

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Section: Discussionsupporting

confidence: 87%

Factors Associated with Adverse Therapeutic Outcomes in People Living with HIV (PLHIV) Monitored in Roi Baudouin Health Care Center, Dakar, Senegal

Ba¹,

Ba²,

Sembene³

et al. 2020

WJA

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“…It is possible that re-starters that were temporarily lost from care may tend to have barriers to care that remain unaddressed upon re-entry, undermining subsequent adherence to treatment. These may be related to lack of access to care and support programs, distance from treatment site, advanced disease stage, or lack of proper adherence counseling [14, 15]. A study in British Columbia [16] describes a slightly different trend in treatment interruption experiences.…”

Section: Discussionmentioning

confidence: 99%

Patients who restart antiretroviral medication after interruption remain at high risk of unfavorable outcomes in Ethiopia

Teklu

Yirdaw

2017

BMC Health Serv Res

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BackgroundAchieving optimal adherence to highly active antiretroviral therapy (HAART) is necessary to attain viral suppression and hence optimal clinical outcome. Interruptions in antiretroviral therapy medication often occur, but a substantial proportion restart treatment. Long-term care engagement practices and clinical outcomes have not been described among cohorts of individuals on HAART in Ethiopia.MethodsIn this study we describe treatment interruption patterns over time among clients who interrupt and subsequently resume HAART, and those who are continuously engaged in treatment, and determine clinical factors associated with loss to engagement.An observational, longitudinal, retrospective cohort design was engaged, using secondary treatment program data. We analyzed differences in treatment interruption among clients who were continuously active and those that interrupted and restarted treatment at months 6, 12, 18, and 24. Cox proportional hazards regression analysis was used to identify predictors of loss from treatment. We estimated time to first treatment interruption, time to restarting after interruption, and time to second interruption. Data from all clients registered to receive HAART in ten study health facilities, from 2005 to 2014, were used to study clinical and treatment outcomes up to 60 months or study end.ResultsIn this study, 39% (8,759/22,647) of clients interrupted treatment for more than 1 month at least at one point during follow-up. Of these, only 35% ever restarted treatment. At the end of follow-up, the hazard of unfavorable treatment outcome (dead, lost, stopped HAART) for clients who restarted treatment at months 6, 12, 18 and 24 was higher by a factor of 1.9, 2.4, 2.6 and 2.4, as compared to those who never discontinued treatment at those times.ConclusionHAART treatment interruption was common in the study population. In those with a history of treatment interruption, long term clinical outcomes were found to be suboptimal. Targeted interventions are required to address follow-up challenges and prevent treatment interruption.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-017-2172-9) contains supplementary material, which is available to authorized users.

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“…Patients may also experience a variety of scheduling conflicts or time constraints (Beckerman et al, 2016; Machine et al, 2016) that may lead to LTFU. For example, time constraints related to travel distance and time may hinder follow-up (Bognounou et al, 2015), as well as scheduling conflicts with other patient activities like work and childcare (Machine et al, 2016).…”

Section: Antecedentsmentioning

confidence: 99%

“…The clinical starter event is any event, incident, or activity that necessitates the need for follow-up in a clinical setting that could be acute, like a spine injury (Sielatycki et al, 2015), or chronic, as for HIV treatment (Bognounou et al, 2015). With a new activity or event, such as a new diagnosis, there is a need to monitor and evaluate progress of the given activity.…”

Section: Defining Attributesmentioning

confidence: 99%

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Being Lost to Follow-Up to Healthcare Appointments: A Concept Analysis

2021

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The concept of being lost to follow-up is very common in healthcare. Though its meaning might seem literal, its use, particularly in healthcare, requires detailed analysis, to understand factors surrounding its incidence and ways of curtailing its detrimental consequences. Walker and Avant’s eight-step concept analysis was used to identify the antecedents, attributes, empirical referents, and consequences of this concept. The attributes of the concept include a clinical starter event suffered by a patient that requires ongoing evaluation by an event tracker at a given location and frequency. However, despite a mutual agreement between the patient and the event tracker, the evaluation suffers a hiatus due to several modifiable and nonmodifiable risk factors (antecedents of the concept), consequences which might include morbidity and death. Early identification and intervention are critical to avoid the occurrence of being lost to follow-up, and nurses need to be cognizant of such knowledge.

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Caractéristiques des patients « perdus de vue » et facteurs déterminants de la perte de vue au cours du suivi des patients infectés par le VIH à Ouagadougou, Burkina Faso

Cited by 8 publications

References 9 publications

Factors Associated with Adverse Therapeutic Outcomes in People Living with HIV (PLHIV) Monitored in Roi Baudouin Health Care Center, Dakar, Senegal

Factors Associated with Adverse Therapeutic Outcomes in People Living with HIV (PLHIV) Monitored in Roi Baudouin Health Care Center, Dakar, Senegal

Patients who restart antiretroviral medication after interruption remain at high risk of unfavorable outcomes in Ethiopia

Being Lost to Follow-Up to Healthcare Appointments: A Concept Analysis

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