Attrition among HIV positive children enrolled under integrated HIV care programme in Myanmar: 12 years cohort analysis
Background: In Myanmar, HIV seropositive children are being enrolled in an integrated HIV care (IHC) Program for HIV treatment and care since 2005. Objectives: To assess the: (a) attrition (death or loss-to-follow-up) rates among children (aged ≥ 18 months to < 15 years) enrolled into the program...
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2018-01-01
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| Series: | Global Health Action |
| Subjects: | |
| Online Access: | http://dx.doi.org/10.1080/16549716.2018.1510593 |
| _version_ | 1819102252476923904 |
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| author | Aung Chan Minn Nang Thu Thu Kyaw Thet Ko Aung Ohn Mar Mon Thurain Htun Myo Minn Oo July Moe Aye Aye Mon Srinath Satyanarayana Htun Nyunt Oo |
| author_facet | Aung Chan Minn Nang Thu Thu Kyaw Thet Ko Aung Ohn Mar Mon Thurain Htun Myo Minn Oo July Moe Aye Aye Mon Srinath Satyanarayana Htun Nyunt Oo |
| author_sort | Aung Chan Minn |
| collection | DOAJ |
| description | Background: In Myanmar, HIV seropositive children are being enrolled in an integrated HIV care (IHC) Program for HIV treatment and care since 2005. Objectives: To assess the: (a) attrition (death or loss-to-follow-up) rates among children (aged ≥ 18 months to < 15 years) enrolled into the programme before and after initiation of anti-retroviral therapy (ART) (pre-ART and ART periods); (b) demographic and clinical factors associated with attrition during these two periods. Methods: Children enrolled in IHC Programme and their status (death, lost to follow-up, regular follow-up or transferred out) was assessed as on 30 June 2017. Attrition rates (per 100 person-years) at pre – ART and ART periods were calculated and the association between demographic and clinical characteristics with attrition was assessed using Cox proportional hazards model. Results: Among 2,736 children enrolled, pre-ART attrition rate was 19 per 100 person-years of follow-up (95% CI: 17–21) and ART attrition rate was 4 per 100 person-years of follow-up (95% CI: 3–4) with higher levels during the initial few months of enrolment. The 36-month retention rates during pre-ART period was 75% (95% CI: 72–78) and during ART period was 87% (95% CI: 86–88). The children ‘at enrolment’ with relatively lower levels of haemoglobin, immune deficiency, underweight for age, higher WHO clinical stages, presence of hepatitis B infection had higher hazards of attrition in both periods. Conclusion: The attrition rates are high particularly among children with relatively poorer clinical, nutritional profiles at enrolment. The study suggests the urgent need for improving adherence counselling especially during the initial few months of enrolment and early ART initiation. |
| first_indexed | 2024-12-22T01:31:37Z |
| format | Article |
| id | doaj.art-966b862347654af0813d7013b8eecb32 |
| institution | Directory Open Access Journal |
| issn | 1654-9716 1654-9880 |
| language | English |
| last_indexed | 2024-12-22T01:31:37Z |
| publishDate | 2018-01-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Global Health Action |
| spelling | doaj.art-966b862347654af0813d7013b8eecb322022-12-21T18:43:29ZengTaylor & Francis GroupGlobal Health Action1654-97161654-98802018-01-0111110.1080/16549716.2018.15105931510593Attrition among HIV positive children enrolled under integrated HIV care programme in Myanmar: 12 years cohort analysisAung Chan Minn0Nang Thu Thu Kyaw1Thet Ko Aung2Ohn Mar Mon3Thurain Htun4Myo Minn Oo5July Moe6Aye Aye Mon7Srinath Satyanarayana8Htun Nyunt Oo9Myanmar country officeMyanmar country officeMyanmar country office550 bedded Children HospitalMyanmar country officeMyanmar country officeMyanmar country officeMyanmar country officeInternational Union Against Tuberculosis and Lung DiseasesMinistry of Health and SportsBackground: In Myanmar, HIV seropositive children are being enrolled in an integrated HIV care (IHC) Program for HIV treatment and care since 2005. Objectives: To assess the: (a) attrition (death or loss-to-follow-up) rates among children (aged ≥ 18 months to < 15 years) enrolled into the programme before and after initiation of anti-retroviral therapy (ART) (pre-ART and ART periods); (b) demographic and clinical factors associated with attrition during these two periods. Methods: Children enrolled in IHC Programme and their status (death, lost to follow-up, regular follow-up or transferred out) was assessed as on 30 June 2017. Attrition rates (per 100 person-years) at pre – ART and ART periods were calculated and the association between demographic and clinical characteristics with attrition was assessed using Cox proportional hazards model. Results: Among 2,736 children enrolled, pre-ART attrition rate was 19 per 100 person-years of follow-up (95% CI: 17–21) and ART attrition rate was 4 per 100 person-years of follow-up (95% CI: 3–4) with higher levels during the initial few months of enrolment. The 36-month retention rates during pre-ART period was 75% (95% CI: 72–78) and during ART period was 87% (95% CI: 86–88). The children ‘at enrolment’ with relatively lower levels of haemoglobin, immune deficiency, underweight for age, higher WHO clinical stages, presence of hepatitis B infection had higher hazards of attrition in both periods. Conclusion: The attrition rates are high particularly among children with relatively poorer clinical, nutritional profiles at enrolment. The study suggests the urgent need for improving adherence counselling especially during the initial few months of enrolment and early ART initiation.http://dx.doi.org/10.1080/16549716.2018.1510593Attritiondeathlost to follow upretentionchildrenHIVSORT-IT |
| spellingShingle | Aung Chan Minn Nang Thu Thu Kyaw Thet Ko Aung Ohn Mar Mon Thurain Htun Myo Minn Oo July Moe Aye Aye Mon Srinath Satyanarayana Htun Nyunt Oo Attrition among HIV positive children enrolled under integrated HIV care programme in Myanmar: 12 years cohort analysis Global Health Action Attrition death lost to follow up retention children HIV SORT-IT |
| title | Attrition among HIV positive children enrolled under integrated HIV care programme in Myanmar: 12 years cohort analysis |
| title_full | Attrition among HIV positive children enrolled under integrated HIV care programme in Myanmar: 12 years cohort analysis |
| title_fullStr | Attrition among HIV positive children enrolled under integrated HIV care programme in Myanmar: 12 years cohort analysis |
| title_full_unstemmed | Attrition among HIV positive children enrolled under integrated HIV care programme in Myanmar: 12 years cohort analysis |
| title_short | Attrition among HIV positive children enrolled under integrated HIV care programme in Myanmar: 12 years cohort analysis |
| title_sort | attrition among hiv positive children enrolled under integrated hiv care programme in myanmar 12 years cohort analysis |
| topic | Attrition death lost to follow up retention children HIV SORT-IT |
| url | http://dx.doi.org/10.1080/16549716.2018.1510593 |
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