True outcomes for patients on antiretroviral therapy who are "lost to follow-up" in Malawi
PROBLEM: In many resource-poor countries that are scaling up antiretroviral therapy (ART), 5-25% of patients are reported as "lost to follow-up". This figure is 9% in Malawi. There is no published information about the true outcome status of these patients. APPROACH: In four facilities in...
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| Format: | Article |
| Language: | English |
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The World Health Organization
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| Series: | Bulletin of the World Health Organization |
| Online Access: | http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0042-96862007000700013&lng=en&tlng=en |
| _version_ | 1827337261200441344 |
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| author | Joseph Kwong-Leung Yu Solomon Chih-Cheng Chen Kuo-Yang Wang Chao-Sung Chang Simon D Makombe Erik J Schouten Anthony D Harries |
| author_facet | Joseph Kwong-Leung Yu Solomon Chih-Cheng Chen Kuo-Yang Wang Chao-Sung Chang Simon D Makombe Erik J Schouten Anthony D Harries |
| author_sort | Joseph Kwong-Leung Yu |
| collection | DOAJ |
| description | PROBLEM: In many resource-poor countries that are scaling up antiretroviral therapy (ART), 5-25% of patients are reported as "lost to follow-up". This figure is 9% in Malawi. There is no published information about the true outcome status of these patients. APPROACH: In four facilities in northern Malawi, ART registers and master cards were used to identify patients who had not attended the facility for 3 months or more and were thus registered as "lost to follow-up". Clinic staff attempted to trace these patients and ascertain their true outcome status. LOCAL SETTING: Of 253 patients identified as "lost to follow-up", 127 (50%) were dead, 58% of these having died within 3 months of their last clinic visit. Of the 58 patients (23%) found to be alive, 21 were still receiving ART and 37 had stopped treatment (high transport costs being the main reason for 13 patients). Sixty-eight patients (27%) could not be traced, most commonly because of an incorrect address in the register. Fewer patients were alive and more patients could not be traced from the central hospital compared with the peripheral hospitals. RELEVANT CHANGES:Better documentation of patients’ addresses and prompt follow-up of patients who are late for their appointments are required. LESSONS LEARNED: ART clinics in resource-poor countries should ensure that patients’ addresses are correct and comprehensive. Clinics should also undertake contact tracing as soon as possible in the event of non-attendance, consider facilitating access to ART clinics and take loss to follow-up into consideration when assessing death rates. |
| first_indexed | 2024-03-07T18:50:22Z |
| format | Article |
| id | doaj.art-5ce9dce82f83465b9a75cd1db755af8c |
| institution | Directory Open Access Journal |
| issn | 0042-9686 |
| language | English |
| last_indexed | 2024-03-07T18:50:22Z |
| publisher | The World Health Organization |
| record_format | Article |
| series | Bulletin of the World Health Organization |
| spelling | doaj.art-5ce9dce82f83465b9a75cd1db755af8c2024-03-02T01:49:34ZengThe World Health OrganizationBulletin of the World Health Organization0042-968685755055410.1590/S0042-96862007000700013S0042-96862007000700013True outcomes for patients on antiretroviral therapy who are "lost to follow-up" in MalawiJoseph Kwong-Leung Yu0Solomon Chih-Cheng Chen1Kuo-Yang Wang2Chao-Sung Chang3Simon D Makombe4Erik J Schouten5Anthony D Harries6Mzuzu Central HospitalPingtung Christian HospitalPingtung Christian HospitalPingtung Christian HospitalMinistry of HealthMinistry of HealthMinistry of HealthPROBLEM: In many resource-poor countries that are scaling up antiretroviral therapy (ART), 5-25% of patients are reported as "lost to follow-up". This figure is 9% in Malawi. There is no published information about the true outcome status of these patients. APPROACH: In four facilities in northern Malawi, ART registers and master cards were used to identify patients who had not attended the facility for 3 months or more and were thus registered as "lost to follow-up". Clinic staff attempted to trace these patients and ascertain their true outcome status. LOCAL SETTING: Of 253 patients identified as "lost to follow-up", 127 (50%) were dead, 58% of these having died within 3 months of their last clinic visit. Of the 58 patients (23%) found to be alive, 21 were still receiving ART and 37 had stopped treatment (high transport costs being the main reason for 13 patients). Sixty-eight patients (27%) could not be traced, most commonly because of an incorrect address in the register. Fewer patients were alive and more patients could not be traced from the central hospital compared with the peripheral hospitals. RELEVANT CHANGES:Better documentation of patients’ addresses and prompt follow-up of patients who are late for their appointments are required. LESSONS LEARNED: ART clinics in resource-poor countries should ensure that patients’ addresses are correct and comprehensive. Clinics should also undertake contact tracing as soon as possible in the event of non-attendance, consider facilitating access to ART clinics and take loss to follow-up into consideration when assessing death rates.http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0042-96862007000700013&lng=en&tlng=en |
| spellingShingle | Joseph Kwong-Leung Yu Solomon Chih-Cheng Chen Kuo-Yang Wang Chao-Sung Chang Simon D Makombe Erik J Schouten Anthony D Harries True outcomes for patients on antiretroviral therapy who are "lost to follow-up" in Malawi Bulletin of the World Health Organization |
| title | True outcomes for patients on antiretroviral therapy who are "lost to follow-up" in Malawi |
| title_full | True outcomes for patients on antiretroviral therapy who are "lost to follow-up" in Malawi |
| title_fullStr | True outcomes for patients on antiretroviral therapy who are "lost to follow-up" in Malawi |
| title_full_unstemmed | True outcomes for patients on antiretroviral therapy who are "lost to follow-up" in Malawi |
| title_short | True outcomes for patients on antiretroviral therapy who are "lost to follow-up" in Malawi |
| title_sort | true outcomes for patients on antiretroviral therapy who are lost to follow up in malawi |
| url | http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0042-96862007000700013&lng=en&tlng=en |
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