Patient retention and attrition on antiretroviral treatment at district level in rural Malawi

Massaquoi, Moses; Zachariah, Rony; Manzi, Marcel; Pasulani, O.; Misindi, Dalitso; Mwagomba, Beatrice; Bauernfeind, Ariane; Harries, Anthony

doi:10.1016/j.trstmh.2009.02.012

Cited by 89 publications

(96 citation statements)

References 15 publications

(18 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…So, data collection tool was tested on similar participants at Mchinji District Hospital, ART clinic which is more than 50 kilometers from Lilongwe city, but has the same Chewa tribe of people. Moreover, we controlled a lot of confounders in this study by proper participants' selection and clearly matching the dependent and independent variables [13]. Use of multivariate and logistic regression intensified our confounding control.…”

Section: Methodsmentioning

confidence: 99%

Factors That Influence Anti-Retroviral Therapy Adherence among Women in Lilongwe Urban Health Centres, Malawi

Mbirimtengerenji¹,

Jere²,

Lengu³

et al. 2013

WJA

View full text Add to dashboard Cite

Introduction: Sub-Saharan Africa remains most severely affected, with nearly 1 in every 20 adults (4.9%) living with HIV and this is accounting for 69% of the people worldwide. Although the regional prevalence of HIV infection is nearly 25 times higher in sub-Saharan Africa than in Asia, almost 5 million people are living with HIV in South, South-East and East Asia combined. Purpose: The purpose of this study was to find out the factors that influence anti-retroviral therapy adherence among women in Lilongwe Urban, Malawi. Methods: A descriptive cross-sectional design was used to study multi sites using quantitative methods. The sites were ART clinics at Area 18 health centre, and Area 25 health centre. A questionnaire was used to a convenient sample of 118 HIV positive women. Quantitative data from close-ended questions were coded and analyzed using the Statistical Package for Social Science (SPSS), version 16. Logistic regression model was used to execute the potential covariates. Findings: ART adherence among women is influenced by knowledge levels on: perceived importance and consequences for not adhering to ART; Short waiting time; good relationships with the next of kin and service providers; trust and effective coping mechanisms to stressful events. Source of information was highly associated with adherence in the logistic regression OR ≤ 2.89; CI (1.66 ± 5.38); p (0.039). Moreover, Short waiting time of the women at the hospital during the ARV refill period is highly associated with ART adherence level OR ≤ 4.11; CI (2.05 ± 6.12); p (0.021). On the other hand, factors that contribute to non-adherence are reduced knowledge level p-0.002; Side effects of ART; bad relationships with service providers and relationship with the next of kin as well as occupation of the clients (women). Conclusion: Despite stressful events to HIV positive living women, this study revealed that the majority of these participants would continue taking ART if the factors are very minimal. Encouraging the women who stop taking ART particularly in urban health centres due to such factors like religious beliefs that God is superior and will heal them would influence the ART survival rate in Malawi.

show abstract

Section: Methodsmentioning

confidence: 99%

Factors That Influence Anti-Retroviral Therapy Adherence among Women in Lilongwe Urban Health Centres, Malawi

Mbirimtengerenji¹,

Jere²,

Lengu³

et al. 2013

WJA

View full text Add to dashboard Cite

show abstract

“…None of the studies evaluated ART coverage. All studies reported improved retention in care [45][46][47][48] (overall estimate RR 1.12, 95% CI 1.08-1.17, Figs 4 and 5). Three studies reported reduced mortality [46][47][48], although one estimate lacked statistical significance [47], whereas one study reported increased mortality [45] (Fig.…”

Section: Full Decentralization Of Antiretroviral Therapymentioning

confidence: 96%

Improving antiretroviral therapy scale-up and effectiveness through service integration and decentralization

Suthar

Rutherford²,

Horváth³

et al. 2014

AIDS

View full text Add to dashboard Cite

Integrating ART into MNCH, TB, and OST services was often associated with improvements in ART coverage, and decentralization of ART into primary health facilities and communities was often associated with improved retention. Neither integration nor decentralization was associated with adverse outcomes. These data contributed to recommendations in the WHO 2013 consolidated antiretroviral guidelines to integrate ART delivery into MNCH, TB, and OST services and to decentralize ART.

show abstract

“…The argument that decentralisation of ART services is impossible because of lack of trained staff , weak infrastructure, and poor drug security is unpersuasive; health centres in rural areas can achieve good treatment outcomes with ART. 122 International policy calls for task shifting in HIV care 41,112,123 have been heeded, and eff ective nurse-driven ART in primary care is already a reality. 124 At least in the short-to-medium term, equivalent ART outcomes can be achieved through a public health approach without the need for sophisticated laboratory monitoring.…”

Section: Collaborationmentioning

confidence: 99%

The HIV-associated tuberculosis epidemic—when will we act?

et al. 2010

View full text Add to dashboard Cite

Journal LancetRights Reproduced on this site with permission of Elsevier Ltd. Please see [url] Tuberculosis 3The HIV-associated tuberculosis epidemic-when will we act? Anthony D Harries, Rony Zachariah, Elizabeth L Corbett, Stephen D Lawn, Ezio T Santos-Filho, Rhehab Chimzizi, Mark Harrington, Dermot Maher, Brian G Williams, Kevin M De Cock Despite policies, strategies, and guidelines, the epidemic of HIV-associated tuberculosis continues to rage, particularly in southern Africa. We focus our attention on the regions with the greatest burden of disease, especially sub-Saharan Africa, and concentrate on prevention of tuberculosis in people with HIV infection, a challenge that has been greatly neglected. We argue for a much more aggressive approach to early diagnosis and treatment of HIV infection in aff ected communities, and propose urgent assessment of frequent testing for HIV and early start of antiretroviral treatment (ART). This approach should result in short-term and long-term declines in tuberculosis incidence through individual immune reconstitution and reduced HIV transmission. Implementation of the 3Is policy (intensifi ed tuberculosis case fi nding, infection control, and isoniazid preventive therapy) for prevention of HIV-associated tuberculosis, combined with earlier start of ART, will reduce the burden of tuberculosis in people with HIV infection and provide a safe clinical environment for delivery of ART. Some progress is being made in provision of HIV care to HIV-infected patients with tuberculosis, but too few receive co-trimoxazole prophylaxis and ART. We make practical recommendations about how to improve this situation. Early HIV diagnosis and treatment, the 3Is, and a comprehensive package of HIV care, in association with directly observed therapy, short-course (DOTS) for tuberculosis, form the basis of prevention and control of HIV-associated tuberculosis. This call to action recommends that both HIV and tuberculosis programmes exhort implementation of strategies that are known to be eff ective, and test innovative strategies that could work. The continuing HIV-associated tuberculosis epidemic needs bold but responsible action, without which the future will simply mirror the past.

show abstract

Patient retention and attrition on antiretroviral treatment at district level in rural Malawi

Cited by 89 publications

References 15 publications

Factors That Influence Anti-Retroviral Therapy Adherence among Women in Lilongwe Urban Health Centres, Malawi

Factors That Influence Anti-Retroviral Therapy Adherence among Women in Lilongwe Urban Health Centres, Malawi

Improving antiretroviral therapy scale-up and effectiveness through service integration and decentralization

The HIV-associated tuberculosis epidemic—when will we act?

Contact Info

Product

Resources

About